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Author Topic: parametics being aloud to stick accesses for IV access?  (Read 2039 times)
sullidog
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« on: July 17, 2011, 08:17:07 PM »

From what I've heard from parametics that I know a parametic is aloud to use someones fistula or graft as an IV access if it's an emergency situation, I think someone needs to train these people and tell them even in an emergency an access should not be used only by the dialysis clinic. I've heard of several parametics doing this.
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May 13, 2009, went to urgent care with shortness of breath
May 19, 2009, went to doctor for severe nausea
May 20, 2009, admited to hospital for kidney failure
May 20, 2009, started dialysis with a groin cath
May 25, 2009, permacath was placed
august 24, 2009, was suppose to have access placement but instead was admited to hospital for low potassium
august 25, 2009, access placement
January 16, 2010 thrombectomy was done on access
Hemodoc
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« Reply #1 on: July 17, 2011, 08:30:38 PM »

If you are looking at a true life threatening emergency with no other options, then have at it. What is the sense of preserving the fistula in a dead patient who has no other access.

On the other hand, the fistula should be  hands off in a situation that is not a threat of immediate death.

Not sure what they are teaching paramedics, but that is just common sense.  Hopefully they slap a little alcohol on it first to prevent risk of infection and sepsis.  When it comes to a code situation, the quicker you get the right meds into a patient, the more likely they will survive but even then the odds are stacked against a person in full cardiac arrest.
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Peter Laird, MD
www.hemodoc.info
Diagnosed with IgA nephropathy 1998
Incenter Dialysis starting 2-1-2007
Self Care in Center from 4-15-2008 to 6-2-2009
Started  Home Care with NxStage 6-2-2009 (Qb 370, FF 45%, 40L)

All clinical and treatment related issues discussed on this forum are for informational purposes only.  You must always secure your own medical teams approval for all treatment options before applying any discussions on this site to your own circumstances.
Ang
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« Reply #2 on: July 17, 2011, 09:08:46 PM »

in an emergency use whats at your disposal :thumbup;


As in my own case , my veins are pretty well cactus when it comes to labs
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The Lady
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« Reply #3 on: July 18, 2011, 04:42:05 PM »

My veins are crap, and when I went to have fistula surgery last month, they had to use my permacath as an IV.

That surgery failed, so I suspect they will be doing it again when we do the graft next.

They were very sterile about it, and actually for a few weeks after my cath worked better than ever. It's like the fluids and meds gave it a good cleaning out.
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sullidog
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« Reply #4 on: July 18, 2011, 06:48:47 PM »

Yeah that's a good point, I just thought your access was hands off al together, and yes they did use my cath as an IV when doing fistula surgery but the doctor had to approve it first. They let the dialysis nurses handle it though as they didn't wanna do something wrong.
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May 13, 2009, went to urgent care with shortness of breath
May 19, 2009, went to doctor for severe nausea
May 20, 2009, admited to hospital for kidney failure
May 20, 2009, started dialysis with a groin cath
May 25, 2009, permacath was placed
august 24, 2009, was suppose to have access placement but instead was admited to hospital for low potassium
august 25, 2009, access placement
January 16, 2010 thrombectomy was done on access
texasstyle
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« Reply #5 on: July 18, 2011, 08:36:35 PM »

ith a recent experience we had with my husband I would'nt have cared if it went into fistula. Heart rate was 40 in ambulance. As soon as they wheeled him into ER, he "coded" twice. If that happened in the ambulance they would have had to give him medicine immedietly. he heart went into v tach(?)-where the heart goes all crazy out of rythm. It's like the oppisite end of flat lLining with same outcome. In times like this you have seconds. Sometimes getting an IV line regularly is hard enough. Just my 2 cents lol
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caregiver to husband using in-center dialysis 4 years
silverhead
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« Reply #6 on: July 18, 2011, 09:41:25 PM »

Several times when I had to call an ambulance for Sharon and we went to the ER, they always had a hard time finding an access to draw blood, and I about went nuts telling them to just give me the needle set and I would get the blood almost instantly for them, but no, they said they were not allowed to get access to the Fistula, and I explained that I was certified to use it daily, so why not hand me the needle and turn around for a moment? I was always so pis*** off at the long delays they caused and let my voice be heard "How come if she goes up 2 floors and has Dialysis I am the one that takes care of all the sticks, but down here I can't".    To no avail unfortunately
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Do not argue with an idiot. He will drag you down to his level and beat you with experience.
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