Welcome everyone to IVchat! Let's begin with intros, tell us about urselves in <140! #IVchat IVchat

Morning all (my time) Glen, NUM - Day Oncology Unit, Brisbane, Downunda. Wed 11 am here, working, full clinic, may be in and out #ivchat chemosabe

Good to see all - Vernon in New Orleans - Critical Care, Nursing History and Hospital Nightmare :) here it learn from #IVchat nursingpins

Hi all, I'm Cora, infusion nurse and moderator for IV chat! Welcome!! #IVchat InfusionNurse

I'm Crystal - I do social media for the NursingLink community! #ivchat NursingLink

@chemosabe Hi Glen, thank u for joining ur first IV chat. we're so happy u can join today! #IVchat IVchatHi! I'm Teresa, from Long Island, NY and a staff development instructor #ivchat NurseEducator@NursingLink Welcome Crystal, thanks for joining! Good to see u! #IVchat IVchat

@IVchat thanks, have kept missing it for past 6 months or so... #ivchat chemosabe

@nurseeducator Good to see ya. #IVchat nursingpins

as always, glad to be here #ivchat NursingLink@nurseeducator Hi Teresa, thanks for joining! Welcome! #IVchat IVchat

@nurseeducator Hi Teresa, good to see u tonite. #IVchat InfusionNurse

@nursingpins Hey Vernon, howdy! #IVchat InfusionNurse

Yay, so happy to see a lot of our twitter colleagues on tonite. Thank you for joining. First topic coming up next #IVchat IVchat

@nursingpins good to see you too! #ivchat NurseEducator@InfusionNurse Happy to be here! Hopefully a delayed visit! #ivchat NurseEducatorTopics will be numbered, pls, prepend w/ topic # when replying #IVchat IVchatT1 - Use of otoscope for finding veins? Ur thoughts? any experience? #IVchat IVchat

T1 - honestly, I have not used an otoscope to help find veins...not sure how to use it. #IVchat InfusionNurse

T1 Have never used an otoscope - may need to? #IVchat nursingpinsT1 never done it...but can't see y it couldn't work... tend to send our diff accesses for u/s guided cannulae #ivchat chemosabe

T1 - of course, its not an approved use for an otoscope. #IVchat InfusionNurse

RT @IVchat: Welcome everyone to IVchat! Let's begin with intros, tell us about urselves in <140! #IVchat "interesting chat to checkout" ctsinclair

T1 but for that matter, don't most nurses carry a led torch/flashlight these days? #ivchat chemosabe

T1 - its interesting but found this article on other uses of otoscope..http://bit.ly/gTTP3i #IVchat IVchat

T1 Never used one either for finding veins either! Thinking light might help #ivchat NurseEducator

Nurses: going on right now is #IVchat. Check it out. #RNchat RNchat

Yes, not for finding veins. RT @InfusionNurse: T1 - of course, its not an approved use for an otoscope. #IVchat IVchat

light not enough to illuminate? RT @chemosabe: T1 but for that matter, dont most nurses carry a led torch/flashlight these days? #IVchat InfusionNurse

Nurses: there's a chat just for you. starts NOW. find it at #ivchat infoployment

T1 The beam of otoscope light illuminate the tissues of the arms of young infantsfacilitate the location of veins, #IVchat IVchat

T1 (cont) appear as dark lines accessible for venipuncture...accdg to the article.. #IVchat IVchat

RT @IVchat: T1 The beam of otoscope light illuminate the tissues of the arms of young infantsfacilitate the location of veins, #IVchat InfusionNurse@InfusionNurse probably not...just trying to be creative, besides, don't know that I have an otoscope on my unit...or good batts #ivchat chemosabe

@IVchat T1 The beam of otoscope light illuminate the tissues of the arms of young infant ... only useful in infants then maybe... #ivchat chemosabe

Yes, accdg to that article RT @nurseeducator: T1 Never used one either for finding veins either! Thinking light might help #IVchat IVchat

RT @IVchat: T1 - its interesting but found this article on other uses of otoscope..http://bit.ly/gTTP3i #IVchat IVchat@chemosabe perhaps, accdg to that article. I deal w/ adults mainly #IVchat InfusionNurse

@InfusionNurse perhaps, accdg to that article. I deal w/ adults mainly ... likewise #ivchat chemosabe

T1 I did use a foot operated X-ray viewing light once-same thing I guess. :) Will try it next time I'm grasping for straws-otoscope #IVchat nursingpins

T1 I'm concerned off label use of otoscope here when there r approved devices to find veins..any1 use those? #IVchat InfusionNurse

T1 paeds and infs tend to have a more translucent tissue that would be more suited to use of light for venous outlining... #ivchat chemosabe

@nursingpins to light up the veins...yes, maybe.. #IVchat IVchat

@InfusionNurse bard in Oz promote or sell small uss devices #ivchat chemosabe

good point! T @chemosabe: T1 paeds and infs tend more translucent tissue that would be more suited 2 use of light 4 venous outlining #IVchat IVchat

T1 - have not seen one of those foot operated lights in years - will have to settle for the otoscope. #IVchat nursingpins

@chemosabe Is that used to find veins for PICC insertion or peripheral IV insertion? #IVchat InfusionNurse

Plan B otoscope RT @nursingpins: T1 - have not seen 1 of those foot operated lights in years - will have to settle for the otoscope. #IVchat IVchat

@InfusionNurse promoted for PICC and Midline insertion, but do not see y would not be suitable for exp practitioner with PIVC #ivchat chemosabe

T1 - Was going to ask - any new tips for PICC lines that flush w/o resistance but will not draw - many more PICC lines used now. #IVchat nursingpins

@nursingpins as in no bld return? #IVchat InfusionNurse

@chemosabe many US device r not for PIV insertions, there r devices avail here in the Stated 4 PIV use. #IVchat IVchat

T1 Yes - many nurses drawing from them now - seems like a lg # quit drawing? #IVchat nursingpins

@IVchat sure there are down here too... cost is the issue... #ivchat chemosabe

@nursingpins ..then there's a prob w/ the line, mayb fibrin buidlup..might need to use cathflo.. #IVchat InfusionNurse

@chemosabe So true, cost of those devices is a concern, perhaps hard to justify for PIV only #IVchat IVchat

T1 some hosps have a policy for tpa (PICC) lines - some don't - nurses are taking a risk w/o policy. #IVchat nursingpins

@IVchat precisely y have not invested in any to this point in time... particularly wen our med imaging depart will do them 4 us... #ivchat chemosabe@nursingpins...all PICC/central lines shld have a blood return..#ivchat VascularAccess

@nursingpins ..need an order for cathflo - it is approved for clearing lines (not tpa) #IVchat InfusionNurse

T2 - many PICC lines will not draw blood? still flush w/o resistance? #IVchat nursingpins

RT @VascularAccess: @nursingpins...all PICC/central lines shld have a blood return..#ivchat #IVchat IVchat

Next topic coming up... #IVchat IVchat

@chemosabe nice that u have that service, many hosp here dont so nurses have to be creative #IVchat IVchat

we tend to go venogram or portogram to see what patency or alteration of flow is if no flashing back or bleeding. #ivchat chemosabe

@IVchat yes we are fortunate, but still a pain in a$$.. #ivchat chemosabe

RT @nursingpins: T2 - many PICC lines will not draw blood? still flush w/o resistance? #IVchat IVchat

nice RT @chemosabe: we tend to go venogram or portogram to see what patency or alteration of flow if no flashing back or bleeding. #IVchat InfusionNurse

mayb revisit how it is cared 4..RT @nursingpins: T2 - many PICC lines will not draw blood? still flush w/o resistance? #IVchat InfusionNurse

T3 - would honestly say that you follow the 15 sec rule for scrubbing hubs w/ alcohol? #IVchat IVchat

T3 conjecture down here that due to this issue better off not to scrub hubs at all!?!? #ivchat chemosabe

T3 - I must admit I do... :) #IVchat InfusionNurse

T2 thanx for this topic Vernon, apart from Cathflo, which need to clarify for ozzie, was there any other tips? #ivchat chemosabe

15 seconds is rule for handwashing... with alcohol, isn't only until dry? #IVchat swan5675

T3 Cent line care is not consistent here - one of the many things we need standard policy for. #IVchat nursingpins

Really no scrubbing just accessRT @chemosabe: T3 conjecture down here that due to this issue better off not to scrub hubs at all!?!? #IVchat IVchat

T3 personally, wait for glisten to go off hub/injection port/bung whatever we call it #ivchat chemosabe

So sorry! family over for a quick visit #ivchat NurseEducator

@IVchat not so much with piccs and ports but with IMI injections and PIVC bungs yes... not in policy anywhere though...? #ivchat chemosabe

RT @chemosabe: T3 personally, wait for glisten to go off hub/injection port/bung whatever we call it #IVchat InfusionNurse

DefinitelyRT @nursingpins: T3 Cent line care is not consistent here - one of the many things we need standard policy for. #IVchat InfusionNurse

Also 4 hubs RT @swan5675: 15 seconds is rule for handwashing... with alcohol, isnt only until dry? #IVchat InfusionNurse

@nurseeducator no prob, welcome back! #IVchat InfusionNurse

T3 - a concern for CR BSI.. #IVchat IVchat

We have IV team at our hospital to ensure consistency with central line care.On chemo floor we do our own. #IVChat JoyceHarrellRN

@nursingpins ,,there are standards of practice you can use as reference. eg INS standard of practice for infusion nursing #IVchat IVchatT3 - @chemosabe, so if not scrubbing at all, what's ur infection rate? #IVchat InfusionNurse

RT @joyceharrellrn: We have IV team at our hospital to ensure consistency with central line care.On chemo floor we do our own. #IVchat IVchatWe have to obtain dye study before using if no blood return. #IVChat JoyceHarrellRN

@InfusionNurse ahh the beauty/danger of having an inf control depart that does not monitor IV site rates or BSI rates??? #ivchat chemosabe

Good policy to have, wish every1 will do that RT @joyceharrellrn: We have to obtain dye study before using if no blood return. #IVchat InfusionNurse

@joyceharrellrn do u follow same procedure on CL as the IV team? #IVchat InfusionNurse

@IVchat Thanks - So many of NO procedures stem from the (Watch one, Do one, Show one) from The old Charity Hosp. #IVchat nursingpinsLOL..RT @chemosabe: ahh the beauty/danger of having an inf control depart that does not monitor IV site rates or BSI rates??? #IVchat IVchat

RT @InfusionNurse: Good policy to have, wish every1 will do that RT: We have to obtain dye study before using if no blood return. #IVChat JoyceHarrellRN

@InfusionNurse @joyceharrellrn one hosp in Brisbane has nurse led PICC team, and have done since the early nineties... #ivchat chemosabe

RT @InfusionNurse: @joyceharrellrn do u follow same procedure on CL as the IV team? Yes,using the hosp. policies. #IVChat JoyceHarrellRN

RT @chemosabe: @InfusionNurse @joyceharrellrn one hosp in Brisbane has nurse led PICC team, and have done since the early nineties. #IVChat JoyceHarrellRN

I'm an oncology nurse, so we mostly deal with Picc's and Port's on our unit. #IVChat JoyceHarrellRN

Impressive RT @chemosabe:@joyceharrellrn one hosp in Brisbane has nurse led PICC team, and have done since the early nineties... #IVchat InfusionNurse

T3 - back to hub scrubbing, do u think new devices like alcohol impregnated connectors (swabcaps) will help with CRBSI prevention? #IVchat IVchat

another uses the Oncology Nurses to do all PICC and Port care... #ivchat chemosabe

@nursingpins good time to show them the "evidence" or standards!! LOL #IVchat IVchat

T3 - back to hub scrubbing, do u think new devices like alcohol impregnated connectors (swabcaps) will help with CRBSI prevention? #IVChat JoyceHarrellRN

RT @chemosabe: another uses the Oncology Nurses to do all PICC and Port care... Good Idea... #IVChat JoyceHarrellRN

Yes ONS just released the Access Device Guidelines RT @chemosabe: another uses the Oncology Nurses to do all PICC and Port care... #IVchat InfusionNurse

RT @InfusionNurse: Yes ONS just released the Access Device Guidelines RT @chemosabe: another uses the Oncology Nurses #IVchat IVchat

@IVchat You are right - #IVchat nursingpins

T3 best stick to the standards and infection control policies... are injection sites/hubs/bungs routinely changed up there? #ivchat chemosabeI came in a little late. We don't use the impregnated connectors. #IVChat JoyceHarrellRN

T3 - here's info on swabcaps http://bit.ly/eoEbKT (not an endorsement) there r others #IVchat IVchat

@chemosabe. We have policies on when to change needles, drsg changes, hubs. #IVChat JoyceHarrellRN

@chemosabe Changed q 7 days here (with bio-patch) but again not standard. #IVchat nursingpins

Yes RT @chemosabe: T3 are injection sites/hubs/bungs routinely changed up there? #IVchat InfusionNurse

RT @IVchat: T3 - heres info on swabcaps http://bit.ly/eoEbKT (not an endorsement) there r others (Thank you) #IVChat JoyceHarrellRN

RT @IVchat: T3 - heres info on swabcaps http://bit.ly/eoEbKT (not an endorsement) there r others #IVchat InfusionNurse

We change port needles q 6 days, caps after every blood draw, or every 3 days if no blood draw. #IVChat JoyceHarrellRN

RT @joyceharrellrn: We change port needles q 6 days, caps after every blood draw, or every 3 days if no blood draw. #IVchat InfusionNurse@joyceharrellrn 6 days not 7days? just curious most r 7 days #IVchat IVchat

Dont u down there? RT @chemosabe: T3 are injection sites/hubs/bungs routinely changed up there? #IVchat IVchat

T3 just referred to loc pol... swabbed with alco and allowed to dry... bungs changed per manufacturers guidelines... cop out ... #ivchat chemosabe

We do it 6 days. I think it was originally for keeping a flow. Tubing change on CL were every 3 days.So, everything is in sync #IVChat JoyceHarrellRN

RT @chemosabe: T3 just referred to loc pol... swabbed w/ alco, allowed to dry, bungs changed per manufacturers guidelines, cop out #IVchat InfusionNurse

Hey there @nursingpins...Fun topic. #IVChat JoyceHarrellRN@IVchat Dont u down there? anecdotally some hosps in bris not changing bungs routinely on PICCs #ivchat chemosabe

T3 @joyceharrellrn like the idea of 6 days for sync but system-wide we are 7 days #ivchat NurseEducator

Wow, we're almost at an hour, wanted to wrap up a bit early to allow time to switch to #MDchat. Any parting thoughts? #IVchat IVchatYes, do u insert PIVs bevel up or bevel down...LOL..just curious! #IVchat InfusionNurse

@joyceharrellrn Hi - listening - :) and learning. #IVchat nursingpins

nothing more to add, but, thanks, exactly sort of discussions i was anticipating, thanks all #ivchat chemosabe

@InfusionNurse bev up of course... doesn't everyone...? #ivchat chemosabe

@nurseeducator It makes it flow nice. Day three tubing and caps change, day six, tubing, caps, needle.drsg, (unless blood draws) #IVChat JoyceHarrellRNit is changed regularly per policy RT@chemosabe: Dont u down there?anecdotally some hosps in bris not changing bungs routinely PICCs #IVchat InfusionNurse

RT @nursingpins: @joyceharrellrn Hi - listening - :) and learning. Always fun to learn. #IVChat JoyceHarrellRN

@InfusionNurse a few down ugh ... so traumatic ... surprised they are successful? #ivchat chemosabe

RT @InfusionNurse: Mostly said up, a few down RT @chemosabe: @InfusionNurse bev up of course.. (Bev up for me always for any needle) #IVChat JoyceHarrellRN

It's a wrap, thank you so much everyone for joining tonight. It has been fun and interesting!! Good nite all!! #IVchat IVchatHad never heard of bevel down? thought I missed something.- #IVchat nursingpins

good morning all. good sleep #ivchat chemosabe

Thanks Cora and all present. #IVchat nursingpins

Thanks, sorry I got on late. #IVChat JoyceHarrellRN

Yes, a few said down RT @nursingpins: Had never heard of bevel down? thought I missed something.- #IVchat InfusionNurse

Good night! Missed most of a good chat! #ivchat NurseEducatorThanks Glenn RT @chemosabe: good morning all. good sleep #IVchat IVchat

Next IV chat will be Dec. 8 Wed 8PM! #IVchat IVchat

RT @chemosabe: good morning all.good sleep(my days and nights are always messed up.Onc nurse by night, wellness coach by day..:) ) #IVChat JoyceHarrellRN

We missed u too, but summary will be up in a few RT @nurseeducator: Good night! Missed most of a good chat! #IVchat IVchat

Thanks everyone for joining, this was so fun!! Love that Glen could join us from down under. Till next chat. #IVchat InfusionNurse

will put it in my diary... off to physical meeting now! #ivchat chemosabe

@joyceharrellrn @chemosabe @nursingpins @nurseeducator thanks have a wonderful week. Happy Thanksgiving to those in the states. #IVchat InfusionNurse

@InfusionNurse@chemosabe @nursingpins @nurseeducator thanks have a wonderful week.Happy Thanksgiving to those in the states. #IVChat JoyceHarrellRNIV flushes with saline>IV flushes with heparin. #ebp #IVchat #whatILearned Marcia_Lynn23RT @joyceharrellrn: @InfusionNurse@chemosabe @nursingpins thanks have a wonderful week.Happy Thanksgiving to those in the states. #ivchat NurseEducator

If u all have time, go over to #MDchat now in progress #IVchat IVchat

see my blog http://is.gd/hFPBs RT @nursingpins: Had never heard of bevel down? thought I missed something.- #IVchat InfusionNurse

Saline preferred RT @Marcia_Lynn23: IV flushes with saline>IV flushes with heparin. #ebp #IVchat #whatILearned #IVchat InfusionNurse

Thanks, have a great day!! RT @chemosabe: will put it in my diary... off to physical meeting now! #IVchat IVchat

RT @IVchat: Next IV chat will be Dec. 8 Wed 8PM! #IVchat IVchat

Sad I missed #IVchat today! Hopefully I'll catch the next one. jennparsonage

@swan5675 ..oops, sorry just saw ur tweet, use tweetchat.com next time and enter #IVchat. www.ivchat.org has the summaries of past chats. IVchat@nursinglink - I know its past 5 ur time but thanks for joining #IVchat. IVchat

@IVchat just saw this post. I apparently missed it. #IVchat bthenextstep

just testing........ #IVchat swan5675

kewl! I know how to do this, now. Thanks! Am looking forward to the next chat (When is it?) #IVchat swan5675

I see next chat is December 8 (My birthday...easy to remember.) It is at 8PM....but, in what time zone? I live in Indiana. #IVchat swan5675