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Paper Chase 2 – US Helps with IVs, Except When it Doesn’t

Sanjay Arora, MD and Mike Menchine, MD
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04:14
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Nurses Edition Commentary

Kathy Garvin, RN and Lisa Chavez, RN
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EM:RAP 2016 December Written Summary 910 KB - PDF

Ultrasound guidance for the placement of peripheral IVs was helpful in patients the provider thought would be hard but actually got in the way if the provider thought the IV would be easy.

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Jonah S., RN -

I work at an institution in which RNs (which I am) are able to start USGIVs. I've been trained at USGIVs for less than a year but I know that I start more of these than the rest of the staff combined (we run reports to justify spending the money to train others so we get to set who does them). Speaking from experience I can say that once you've become comfortable with the technique and set up you can start one of these within just a few minutes. It's a completely different technique than typical peripheral IV access and certainly has a learning curve but it is invaluable. When one considers the time it take to finally obtain access on the second, third or other stick attempts the USGIV doesn't sound that bad...and, let's face it, we've all seen patients get stuck five or more times to obtain access. Certainly not an RCT but when I see patients that took multiple attempts prior to my training in USGIVs and now I can get them first stick with an USGIV I've saved time, resources and pain for the patient. This study demonstrates with impressive data why we should be using the USGIV more often in difficult the access patients.

Sean G., M.D. -

wow...if you can easily feel the vein US doesn't add much or anything...and if you can't it does....this is remarkable! A true ingenious paper! Thank God for this type of breakthrough research! It emboldens me to continue with my paper on the following postulate....waiting for days to give acetadote is not as effective as immediately giving it in massive single dose acetaminophen ingestion.

Jonah S., RN -

How many times has something that seems to be obvious been studied with the result being directly oppositional to the obvious answer? That's why studies like this are important. What's more, the quantification of how much better it can be in difficult to access patients helps to encourage its use and saves the patient pain. I think this paper is actually quite useful.

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Pneumonia in the Hotseat Full episode audio for MD edition 227:49 min - 317 MB - M4AEM:RAP 2016 December Aussie Edition Australian 31:23 min - 43 MB - MP3EM:RAP 2016 December Spanish Edition Español 79:39 min - 109 MB - MP3EM:RAP 2016 December Canadian Edition Canadian 16:00 min - 18 MB - MP3EM:RAP 2016 December French Edition Français 30:18 min - 42 MB - MP3EM:RAP 2016 December German Edition Deutsche 94:18 min - 129 MB - MP3EM:RAP 2016 December Written Summary 910 KB - PDFEMRAP 2016 December MP3 Files 183 MB - ZIPEM:RAP 2016 December Board Review Answers 201 KB - PDFEM:RAP 2016 December Board Review Questions 193 KB - PDF

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