Miscellaneous
Bret P. Nelson, MD, RDMS, FACEP Courtesy of Bret Nelson Twitter: @bretpnelson Website: SinaiEM.us YouTube: SinaiEMultrasound Bret Nelson is a Professor of Emergency Medicine, Chief of the Emergency Medicine Ultrasound Division at the Icahn School of Medicine at Mount Sinai, Chief Editor of the ultrasound education website, www.SinaiEM.us. He is on the board of directors of the Society for Clinical Ultrasound Fellowships and active in the American College of Emergency Physicians (ACEP)'s Ultrasound Section and is among the authors of ACEP's Emergency Ultrasound Guidelines. Served on the Board of Directors of the World Interactive Network Focused on Critical Ultrasound (WINFOCUS) and was Chair of the American Institute of Ultrasound in Medicine’s Point of Care Community of Practice. Authored several books, Manual of Emergency and Critical Care Ultrasound, Emergency Medicine Oral Board Review Illustrated, Atlas of Handheld Ultrasound, and Acute Care Casebook. Dr Nelson has lectured throughout the world on the use of point-of-care ultrasound to aid medical decision-making and improve patient safety. His research interests include ultrasound and medical education. "10 years ago a patient will say, 'Only Mary on the 9th floor is going to get near my vessels'....now the patients say, 'I'm a tough stick, so use ultrasound.' It's almost like anyone can get a pass from the patient's perspective...ultrasound is the great equalizer." ~Bret Nelson Can RNs perform USG PIV safely? Yes! Within Nursing Scope of Care!! Yes!! American Institute of Ultrasound in Medicine (AIUM) White Paper in conjunction with: American Academy of Physician Assistants (AAPA) American Association of Critical Care Nurses (AACN) American Association of Nurse Anesthetists (AANA) American Society of Diagnostic and Interventional Nephrology (ASDN) American College of Emergency Physicians (ACEP) American Society of Echocardiography (ASE) Association of Physician Assistants in Cardiovascular Surgery (APACS) Association for Vascular Access (AVA) Infusion Nurses Society (INS) Renal Physicians Association (RPA) Society of Diagnostic Medical Sonography (SDMS) Society for Vascular Ultrasound (SVU) Emergency Nurses Association (ENA) Clinical Practice Guideline for Difficult IV Access Why Nurses? Nurses are masters at IV insertions Ultrasound is another tool in the tool belt for difficult IV access. Ultrasound is a natural progression for nurses who are experienced in obtaining IV access Nurses have the best tricks to get those tough IV lines like applying heat. Nurses already use other technology including infrared light, LED, and head lamps Journal articles show high success rate! ~85 after approximately 10-15 attempts ~95% after approximately 20-25 attempts Too many articles - click here for dropbox link and easy download. Empowering nurses with an advanced skill Nurses are able to identify a patient as a hard stick and obtain IV access with ultrasound without waiting for a physician to place the IV. Nurses who need to develop their IV skills have a skill to strive for. Patient Satisfaction Nurses are able to identify patients who are a hard stick. Patients have reduced failed attempts prior to an ultrasound guided placed IV access. Essentially, patients get stuck less but get good results. Patients know they are a hard stick - they are happy. Who Should be getting USG PIV? Patients who have difficult intravenous access. *If you can place an IV in a conventional or traditional method, do it. ~Yun Cee Identified difficult IV access populations: Oncology/Chemotherapy Sickle Cell Renal/Hemodialysis Obese Repeat Hospital Admissions Shock IV Drug Abuse Diabetic Edematous Dehydration Pediatric Reduces CLABSI by NOT placing central venous lines because you have peripheral IV ac...