This is the first post in the HG & IVs series. If you found this on accident, super! Follow the links to move to the next post in the series, or head back to the intro post if you want to know what to expect in this set of posts. If you are looking for the HG Treatment Series about subcutaneous Zofran or Reglan pumps go here for the intro post to that. So now we know the parts and have all the goodies for the cocktail, let's party!
A large part of the focus home health care nurses seem to have (in my experience) is to make it so that you can independently handle your medical needs. So the official "hook up" part of the IV is the last thing that the nurse does for me unless I need troubleshooting, which is usually them telling me what to do and will be addressed in the next post.
When we left off I had all these supplies out (provided in those boxes of supplies from the home health care co in the mail) and was waiting for the nurse to come out. Usually once she (or he, I just haven't happened to have a male nurse yet) get here they follow the same procedure:
1. Verify I am me.
2. Ask me some basic questions about my stats. (Example: What are your ketones at today?)
3. Examine my arms. (Sigh about the state of my veins)
4. Get their supplies out and sanitize their hands.
5. The poking part.
6. Blood pressure in the other arm and more questions.
Depending on the nurse and how cooperative my veins are this can take 20 minutes or a lot longer.
Before we go any further, this is one of the many I have had with a couple terms labeled. I don't really know all the technical names for everything, but these are the terms I have heard associated with certain pieces.
IVing (yeah, I verbed that) is totally an art form. Some are more naturally able to get a feel for veins than others and honestly it has to be dang hard. Those who say it isn't are probably the people who are just kinda good at it naturally or have a lot of practice.
Personally, I am not bothered by needles but, that said, I cannot watch them give me an IV. I don't look when they poke, and I really can't look if they have to dig. I hate digging or "fishing" as some call it. Call it whatever you want, it is torture and usually results in failure on me.
They do the poking with a needle that has a catheter on the outside of it, much like what is pictured in this post for my pump. Only, and I am just being honest, the needle is bigger. As in longer and thicker. The catheter itself has a colored plastic on it that tells you how thick the needle is, they do this by "gauge." I usually get blue, green is the biggest I have seen and yellow is used in the hands and is smallest. I think. Anyone reading this who knows more please feel free to comment and let me know! Nurses seem to have a preference of their own on what to use, but I find that being assertive and saying what works for me is almost always appreciated.
Once they poke you and are IN the vein (or think they are) they will remove the needle part and leave the catheter in. They then screw the hub on to the catheter and open the line so that fluid starts dripping. Some will use a flush, which was in the labeled picture in the previous post. It is basically a syringe with saline in it.
Weird fact, if they use this and get a vein properly you very well may taste it. Yuck, but it is a good sign because it means they are in. Either way they have to check that fluid is going in and the vein is holding. If your vein blows they need to stop immediately and start over. More on that in the next post.
Once they have the catheter and hub in they have to secure everything. Every nurse seems to have a style for this, like they learn a certain way and like to stick with it. However, some people -- like yours truly -- learn they have a certain way that works for them. I figure since I am the one living with it I have every right to ask for it to be a certain way if possible. I cannot use normal tape, even the paper tape that is supposed to be super gentle makes my wimpy skin react so like mentioned in this post I rely a lot on tegaderm. Usually three sheets secures my IV without tape and gives us a spot to stick the bone, which is the peanut shaped part that holds the loop of IV tubing. The adhesive on the bone is particularly nasty stuff for me, so it is important to rest that on something other than me if possible.
Some pictures of different placements I have had for some reference ... again in the interest of full disclosure, I made some of these black and white because if you look closely you could see some blood in the catheter/hub area. I know that may really bother some people so I removed the color. We will talk a little more about blood in the IV in the next post.
Once they have secured it sometimes they give me the stocking, sometimes not. I like the stocking because it makes me feel like the IV is a little more protected and secure. It also obscures the view of the IV a little which can help if you or someone you love has some anxiety about the IVs.
Either way usually this is the part where they take my vitals, check the baby (after 24 weeks they listen for heartbeat I am told, currently 23 weeks and haven't had that yet) and wrap up the party. Then I just do as much sitting as possible so not to bump it or make anything not work. Speaking of things not working, that will lead us into the third and final post of this series. I will touch a bit on what can go wrong with an IV and when to pull it. So check out the post HG & IVs: The Random Stuff.
None of this is designed to be medical advice that should replace the expertise of a doctor. I am merely sharing my experiences and knowledge, not advising you. I only call myself a "rocket surgeon," I have never been to medical school of any kind and would recommend you get checked by a real professional in the event you have any actual questions. That said, if you would like me to clarify some part of my experience for you, please feel free to ask in the comments!
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