The needle should be inserted at a 10-30 angle with the skin in a slow, continuous motion. 3/2 FULLY RENOVATED HOME JUST $425 DEPOSIT AND NO MORE PAYMENT UNTIL NEXT MOVE!! font-weight: 300;
The procedure to manage arterial air emboli differs from Durants maneuver described above for venous air emboli. Arterial cannulation is characterized by bright red pulsatile blood flow, which produces a waveform if a transducer is attached. MOVE TODAY!! It will review basic principles of patient evaluation and discuss appropriate cannulation techniques and vascular access related complications. Since the catheter provides a portal of entry and a direct pathway to the venous system, an infectious agent can quickly spread throughout the bloodstream, making the patient critically ill (Haddadin & Regunath, 2019). The indications and procedures for insertion and removal, benefits, risks, and complications in conjunction with clinical decision-making for best-practice standards and enhanced patient outcomes will be outlined. There are three categories of IO devices: manual, impact-driven, and drill-powered needles (Gorski et al., 2021). What is expected from a vascular access (theory) The different types of vascular access and needle insertion techniques (theory) How to take care of a vascular access (theory) Refer to Figure 1 for an illustration of the veins within the upper extremity. font-size: 1.2em;
Several options can assist with locating a vein, such as infrared light (e.g., VeinViewer) or an LED light at a specified frequency that highlights deoxygenated blood (e.g., Veinlite LED). E-Learning Modules Learn at your pace, on your schedule. /*width: 100%;
125 Enterprise Drive Version: 3.0. Review due: July 2023. The midline is anchored to the skin with a securement device to reduce the risk of inadvertent dislodgement (Nettina, 2019). Infusion Nurses Society. Wikimedia. We offer continuing education in live workshops and online continuing education classes in vascular access procedures to nurses and other clinicians allowed to perform vascular access procedures. Pathology in the ascending aorta or aortic valve may lead to changes in the arterial waveform. Luxurious Orlando Getaway - Enjoy a 3 Night Orlando Vacation special at Westgate Resorts in Orlando, Florida. margin: 0 0 8px 0;
These catheters are inserted 1.5 inches proximal to the antecubital fossa into the basilic, cephalic, or brachial veins. Several studies have demonstrated that up to 90% of PIVs malfunction before therapy is completed and are removed (Alexandrou et al., 2018). (2016). Arterial blood gases. Campagna, S., Gonella, S., Zerla, P. A., Corona, G., Correggia, T., Mussa, B., & Dimonte, V. (2018). Physicians should claim only the credit commensurate with the extent of their participation in the activity. Although rare (incidence < 0.1%), pseudoaneurysm manifests as a pulsatile mass, typically after local site bleeding or hematoma formation. StatPearls [Internet],https://www.ncbi.nlm.nih.gov/books/NBK430891/, Heffner, A. C., & Androes, M. P. (2021). Step 2: Interactive hands-on training (2 days, 3 hours per day): Participating CRNAs attended 2 hands-on training sessions. Finally, the dorsalis pedis and posterior tibial artery are a long distance from the aorta, often leading to distorted waveforms in adults; however, they may be appropriate for pediatric patients (Butterworth et al., 2013; Gorski et al., 2021). All rights reserved. Pittsburgh, PA 15275 Click below to receive a free, 30-minute phone session, Central Line Care and Maintenance Training, Central Line Patency and Restoration Training, Parenteral Nutrition Administration Training, Central Line Identification Training Course, Central Line Care and Maintenance Training Course, Central Line Dressing Change Training Course, Central Line Patency and Restoration Training Course, Basic IV Access and Insertion Training Course, Advanced IV Access and Insertion Training Course, Parenteral Nutrition Administration Training Course, Peripheral Venous Access (PIV) for Nuclear Medicine Training Course, Request TPN and PPN Administration Education, Request PIV for Nuclear Medicine Education, Overview of the latest in-market central venous access devices and configuration, Best practice guidelines to care for the patient, How to troubleshoot clogged or clotted lines, How to determine and address catheter positioning, How to assess symptoms of central line associated blood stream infections (CLABSI), How to implement Centers for Disease Control recommended Central-Line care Bundles, How to reduce accidental pull outs, develop a, Overview of dressings supporting optimized catheter function, How to determine and identify what supplies are important, How to use a dressing to decrease the chance of infection, Overview of flushing guidelines, drug compatibility, and proper line positioning for line patency, Troubleshooting various issues including central line not flushing or does not have blood return, Overview of proper vein and catheter selection, How to safely secure the peripheral intravenous line, How to use an ultrasound to visualize and select a vein to aid in venous cannulation, Overview of administering TPN through central access, including best practice guidelines, Understand the key differences between TPN and PPN, How to make an effective catheter selection, How to ensure proper TPN delivery, including risk identification and management, Overview of the proper vein and catheter selection, Understand how to use various catheter types & how to use devices safely, How to use ultrasound for needle visualization and vein selection (if available). Vacation in Orlando. The Mark at SoDo offers the best apartments in Orlando with amazing amenities for everyone to enjoy. 2016; 39(1S): S79. WebPICC Resource Associates, LLC offers PICC, IV and other vascular access education to clinicians from all over the country. Excessive hair should be clipped, not shaved. Regardless of the type of VAD utilized, documentation is a critical component of practice. WebStep 1: Obtain Didactic Education Our PICC Education Program consists of 3 separate classes: PICC 101: General Practice PICC Education CLICK HERE TO LEARN MORE PICC 102: Save That PICC Management of Complications CLICK HERE TO LEARN MORE PICC 103: Advanced PICC Placement: The MST Ultrasound Procedure CLICK HERE TO LEARN MORE *Module is to be completed no more than 30 days prior to class. The Gulfcoast Ultrasound Institute designates this internet activity enduring material for a maximum of 4.25 AMA PRA Category 1 Credit(s). Find 15 listings related to Apartments Move Specials in Florida Center on YP.com. 2**. American Journal of Emergency Medicine, 37(4), 715-721. https://doi.org/10.1016/j.ajem.2018.07.031, BruceBlaus. President, Gulfcoast Ultrasound Institute, Inc.St. Monthly Rent $900 - $1,075. This procedure was originally termed the Seldinger technique (ST) and has since been adapted and termed the modified Seldinger (MST, Heffner & Androes, 2021; Stoker, 2009). Creating a better ecosystem is the key to change.
In fact, those actions can lead to serious complications unless the provider has been trained in UGVA protocol. And were here to help, every step of the way. US. https://www.ncbi.nlm.nih.gov/books/NBK499989/, ProfBondi. Healthcare and industry guidelines are ever-evolving. Articles reviewing venous access devices, cancer genetics, immunotherapy, survivorship care, and more. The signs and symptoms of vasospasm include pain in the extremity, decreased arterial pressure, severe damping of the arterial waveform, a loss of arterial pulse, or a significant decrease in pulse oximetry signal quality distal to the cannulation site. Vascular Access Education and training by Vascular Wellness is a comprehensive and unique program that empowers nurses and advances healthcare. }
Most Comprehensive UGVA Course Available. Add-on a Private Hands-On Session or Regularly Scheduled Scan Workshop for Additional Training. PIVs are associated with high complication rates, including insertion difficulty, phlebitis, infiltration, occlusion, dislodgment, and PLABSI. Retrieved April 20, 2021, from https://www.uptodate.com/contents/arterial-blood-gases, Theodore, A. C., Gilles, C., & Dalton, A. With an integral guidewire (most common), the angle should be decreased after pulsatile blood flow is noted so that the needle/guidewire/catheter is nearly parallel to the skin and artery. An upper extremity PIV is only relatively contraindicated in a limb with neuromuscular dysfunction (Frank, 2020). Stainless steel gold bonded chain and bracelet 12mm wide 26-8 wont tarnish ! Earning certification entails completing an accredited vascular sonography program with a vascular technologist school or course and then passing several exams. Associate Professor of Emergency Medicine
Four Midline courses, an Ultrasound Basic course, plus BONUS! Addressing and reducing risks of HAIs in your facility while ensuring patient care is not being compromised due to lack of consistency of best practices. It is also contraindicated in severe peripheral artery disease or active Raynauds syndrome of the intended artery. 2004;30(1):62-67. doi: 10.1007/s00134-003-2045-z, Zimlichman E, Henderson D, Tamir O, et al. Ultrasound-guided vascular access (USGVA) assistance is used more frequently due to increasing age, obesity, and comorbidities in the patient population. Swelling at the site may indicate an extravenous placement. As Vascular Access Experts, Vascular Wellness nurse clinicians are Vascular Access Board Certified (VA-BC), insured, skill-verified, and salaried W2 employees.
The course is designed to facilitate continuous professional development and learning; along with supporting reflective and evidence-based practice. A CRBSI that persists despite 48-72 hours of appropriate antimicrobial coverage should prompt the removal of the infected VAD (Gorski et al., 2021). The HCP should start distally with the dorsal surface of the hand and progress proximally to preserve peripheral access (Alexandrou et al., 2018). Check Availability. Surgical ANTT is used when placing a midline catheter in most institutions (Gorski et al., 2021; Nettina, 2019). text-shadow: none;
This program combines a comprehensive review of ultrasound fundamentals, guidance techniques, ultrasound vessel differentiation, procedural set-up, in-plane and out-of-plane scanning techniques for performing central and peripheral line placement. https://commons.wikimedia.org/wiki/File:2134_Thoracic_Upper_Limb_Veins.jpg, Pedagogy Online Learning Systems. (2015). Since midline catheters and PICC lines are placed in similar locations, documentation in the medical record must indicate which type of line has been inserted. Figure 5 demonstrates a typical arterial line waveform based on placement. WebIt integrates the Vessel Health & Vein Preservation; Infection Control; and ANTT approach. Our Education includes training and through our course offerings, you will build your knowledge and clinical skills. /*text-transform: uppercase;*/
The in-person session is 2.75 hours. Expand Diagnostic & Interventional Services Offered. The flush should be stopped immediately to avoid any additional air from entering the system. Butterworth, J. F., Mackey, D. C., & Wasnick, J. D. (2013). VADs have diagnostic and therapeutic uses, including fluid replacement therapy, intravenous medications, blood products, nutrition, blood sampling, and hemodynamic monitoring (Nettina, 2019). You are a clinical leader responsible for developing educational programs appropriate for your clinicians of varying levels of experience and understanding. Our instructors are all board-certified (VA-BC) vascular access specialists that are experts in the field, and they come with many years of teaching experience. Infusion Therapy Standards of Practice. Email me ! The initial ascent in the waveform corresponds with the ventricular ejection. (2012). Therefore, it is essential to label all arterial lines properly. There is an exaggeration of systolic pressure, a wider pulse pressure, a steeper systolic upstroke, a lower diastolic BP, and a lower/later dicrotic notch as the pressure wave moves peripherally through the arterial tree. Central line complications. We are committed to supporting our customers learning needs by offering a variety of online resources they can access at a time to suit them. Wikimedia. (2017). If the pulsatile flow continues, the guidewire should be advanced with the dominant hand. I am asking $175 obo. With the right training and knowledge, you may potentially reduce vascular access complications and improve patient outcomes. FULLY FURNISHED. Infusion therapy standards of practice, 8th Edition. It optimizes multiple functions into 5 skin care modes, designed to resolve various skin problems. The pathogenesis of catheter-related bloodstream infection with noncuffed short term central venous catheters. 2**. Infiltration occurs when a nonvesicant solution or medication is inadvertently administered into tissue surrounding the catheter site, whereas extravasation occurs when the solution or medication is vesicant.2*When this occurs, the patient may suffer from edema, pain, changes in skin color and fluid leakage from the catheter insertion site, additionally extravasation may progress to blistering and ulceration.2**A myriad of issues may cause infiltration or extravasation, including inappropriate insertion site, inadequate stabilization, difficult access history, medications that alter pain sensation, disease that produces change in vasculature, use of deep veins with insufficient catheter length, and the inability of the patient to report their symptoms.2. Pressure should be applied at the artery and skin puncture sites for at least 5 (radial artery site) to 10 minutes (femoral site) or until bleeding subsides. I am asking $400 obo. 2016; 39(1S): S95. Complications associated with arterial line placement include hematoma, bleeding, vasospasm, arterial thrombosis, embolization of a thrombus, pseudoaneurysm, skin necrosis, infection, nerve damage, necrosis of the extremities or digits, and unintentional intraarterial injection. 1BR at $670. Find More Rentals in Orlando, FL. Learn More Hands-On Training Frost, S. A., Inwood, S., Higgins, N., Lin, F., Alberto, L., Mermel, L., Rickard, C. M., & OMG Study Group. Infusion Nurses Society. Arium Palms at World Gateway - Apartments for rent Arium Palms at World Gateway - 9000 Avenue Pointe Cir, Orlando, FL 32821 : pin. Next, the guidewire is inserted through the catheter into the arterys lumen, well beyond the catheters tip. Outline the advantages and disadvantages of the "In-Plane" and "Out-of-Plane" and the "Direct" vs. "Indirect" ultrasound-guided peripheral vascular access techniques.. Differentiate venous vs. arterial anatomy by ultrasound. 2**. This test involves elevating the wrist with a closed fist to allow the blood to drain from the hand; the investigator then compresses the ulnar and radial arteries. 2. Download this Vascular Access Device Planning Guide, which can walk you through the process of identifying the best solutions to meet unique patient vascular access needs. Int Care Med. WebVascular Access Devices and Intravenous Therapy: Transforming Evidence - 7104NRS Home > Study > Courses > Vascular Access Devices and Intravenous Therapy: Transforming Evidence - 7104NRS Vascular Access Devices and Intravenous Therapy: Transforming Evidence Are you an international student? Patient safety and vein preservation are critical which is why a holistic, comprehensive evaluation and Advanced Lines are significant. $99. is the total price! Intra-arterial catheterization for invasive monitoring: Indications, insertion techniques, and interpretation. Our experienced clinical experts will perform a comprehensive assessment of BD products and clinical practice across your facility, leveraging proprietary digital tools, which will help in developing insightful data. Plus you pay NO RENT to MOVE IN You pay NO RENT to move in! The risk for osteomyelitis, or severe infection of the bone, increases when the dwell time extends beyond 24 hours (Gorski et al., 2021). Arterial Lines. Additional contraindications include the presence of a hemodialysis catheter (e.g., an arteriovenous fistula [AVF]), current or recent infection (e.g., cellulitis), fracture, burn injury, or neuromuscular dysfunction related to a central nervous system injury (e.g., hemiparesis, hemiplegia). The specific duration of these PIV catheters remains controversial and is undetermined at this time. Securing the PIV to limit movement is recommended to reduce the risk of inadvertent dislodgement and thrombophlebitis (Alexandrou et al., 2018; Frank, 2020). Midline catheters are not suitable for continuous vesicant therapy, parenteral nutrition, or the administration of certain types of antibiotics, such as erythromycin (Erythrocin), vancomycin (Vancocin), or nafcillin (Penicillin). Acute Care Nursing CE Package for RNs and LPNs, Price when purchased separately: $4,709.00, identify the different types of vascular access devices (VADs), the standards for insertion, and infection control measures following the 2021 Infusion Nurses Society (INS) Standards of Practice, describe the various types of peripheral intravenous catheters (PIVs), their indications for use, site selection, placement, care, and safety considerations, identify and manage complications for PIVs and patient-specific access by identifying contraindications for site-specific insertion, review specialized VADs, including intraosseous and arterial catheters, and their indications for use, site selection, placement, care, and safety considerations, including complications and contraindications to insertion, explain the interpretation and clinical guidance derived from arterial catheters, using proper hygiene and sterile contact barriers, finding the best vein possible for the IV, checking every day for signs or symptoms of infection, removing or changing the line only when needed, placement of a multi-lumen PICC (2 points), ongoing chemotherapy for a solid tumor/cancer (2 points), receipt of parenteral nutrition (1 point), another CVC at the time of PICC placement (1 point; Herc et al., 2017), date and time of insertion and the number of attempts, identification of insertion site location, radiographic confirmation of tip location if indicated, condition and appearance of potential site complication, specific site preparation, infection control, and safety precautions as appropriate for the procedure, device discontinuation, date, condition, site appearance, dressing applied, the reason for removal, and patient response (Campagna et al., 2018; Gorski et al., 2021), previously used IO site or a recently failed IO attempt, prior orthopedic surgery or implanted orthopedic hardware, infection, severe burns, open wounds, or tissue necrosis at or near the intended site, bone disease such as osteoporosis or osteogenesis imperfecta (Gorski et al., 2021). Describe key nursing consideration of VADs used in the oncology population. I ONLY ONE HOME LEFT!!! Their proposed model performed well and could inform patient selection and surveillance practices for high-risk groups, although it should first be validated for clinical practice. Use my current location. Adams, D. Z., Little, A., Vinsant, C., & Khandelwal, S. (2016). The experience level of the HCP placing the VAD also strongly influences immediate complication rates. WebOur Vascular Access training courses are taught by practicing and certified Vascular Access clinicians (not just educators or trainers), giving all participants an exceptional educational and training experience. WITHIN WALKING DISTANCE TO LAKEFRONT, SHOPPING AND DOWNTOWN GREAT LOCATION AmericanListed features safe and local classifieds for everything you need! Peripheral IV catheter chart. Monday-Friday: 8am - 6pmSaturday-Sunday: 8am - 3pmHolidays: 8am - 1pm. Acquiring information about the latest vascular access innovations that provide both financial efficiencies and improved patient outcomes. }
Reviewed by: Gulfcoast Ultrasound CME Committee, This edition valid for credit through:6/18/2024, .facuBadge {
Vascular access devices (VADs) can be helpful for patients needing frequent access, blood sampling, and long-term in IV therapy. Alternately, PIVs may be secured with an integrated securement device (ISD, e.g., SorbaView), which combines a transparent dressing with built-in securement technology. Linwood Center. - Apartment rentals across Florida. Connect securely to deliver infusions to help ensure safe and consistent medication delivery. Want more than just a PICC Service or PICC Team?Email us below or call 877-284-4435.We are Vascular Access Specialists and here to help and answer your questions. Health care-associated infections: a meta-analysis of costs and financial impact on the US health care system. The INS standards also address the global COVID-19 pandemic, highlighting the need to expand standard precautions (e.g., fit-tested certified N95 respirators and additional hand hygiene protocols) to prevent cross-contamination for HCP and patient safety (Gorski et al., 2021). BSI can lead to sepsis, shock, and death. If blood pressure accuracy is in question or the electronic pressure monitoring cable becomes disconnected, this zeroing procedure should be repeated. Figure 2 shows the key distinctions between a midline catheter and a PICC line. Paediatric Anesthesia, 121(6), 1332-1337. https://doi.org/10.1016/j.bja.2018.08.008. Our education also consists of skills verification by a preceptor to validate compliance with our competencies. WebExplore and learn from a comprehensive curriculum in vascular access. 2019 PICC Excellence, Inc. Quicker therapy leads to better outcomes. From selecting the program that's right for you to understanding and preparing for certification, SVS has the resources you need to navigate your vascular training for all training pathways. This catheter should be removed, pressure should be applied, and a dressing should be placed over the area. J Infus Nurs. The INS standards recommend chlorhexidine-impregnated dressings for patients over 18 with arterial access devices (Gorski et al., 2021). J Infus Nurs. Infusion Therapy Standards of Practice. TA and ISD procedures mirror those described for short PIVs. Web(-) Remove Ultrasound filter Ultrasound (-) Remove Vascular filter Vascular (-) Remove MRI filter Remove MRI filter The use of ultrasound guidance with VAD insertion has improved insertion success and reduced premature catheter failure (Bahl et al., 2019; Kornbau et al., 2015). Arterial catheters are also contraindicated in those with a platelet count below 50,000/L (50 x 109/L). Once a flash of blood in the chamber is visualized, the angle of the catheter should be lowered, and the tip advanced another 1-2 mm to ensure the entire catheter tipnot just the needle tiphas been inserted into the lumen of the vein. Short PIVs are not appropriate for continuous vesicant therapy, parenteral nutrition, infusions with a pH below 5 or above 9, or infusions with an osmolality over 900 mOsm/L (Gorski et al., 2021; Nettina, 2019). 2**. Midline catheters should be considered for patients who need intermediate-term IV therapy when standard PIV access is difficult. SVU members receive FREE access to more than 40 hours of CME Credit. Other risk factors include low cardiac output, peripheral artery disease, and vasospastic disorders (e.g., Raynauds syndrome). Journal of Infusion Nursing, 44(1S), S1-S224. Elevated pulse pressure may indicate age-associated vascular stiffness. This price includes Labor, Tax, parts out the door. A midline catheter should not be placed in patients with a history of thrombosis, hypercoagulable blood clotting disorders, or currently decreased venous flow. Clinical Professor of Emergency MedicineClinical Director, POCUS EducationSolomont Simulation CenterDepartment of Emergency MedicineBoston Medical CenterBoston, MANo relevant financial relationships to disclose. A 20G catheter is recommended for adults and simplifies blood sampling and vigorous waveform interpretation (Gorski et al., 2021). https://doi.org/10.12788/jhm.3039, Bahl, A., Hang, B., Brackney, A., Joseph, S., Karabon, P., Mohammad, A., Nnanabu, I., & Shotkin, P. (2019). A model to predict central-line-associated bloodstream infection among patients with peripherally inserted central catheters: The MPC score. J Infus Nurs. At BestVacationDealz,com, our business is providing people with vacations experiences they will treasure for years. In addition, specialized VADs include intraosseous catheters (IO) and arterial lines (Kornbau et al., 2015). min-height: 200px;*/
Retrieved April 23, 2021, from https://www.uptodate.com/contents/overview-of-central-venous-access-in-adults, Herc, E., Patel, P., Washer, L., Conion, A., Flanders, S., & Chopra, V. (2017). Emergently, PIV access can be established in the antecubital fossa if needed, but this is not the first choice for nonemergent access. }. American Journal of Infection Control, 44(12), 14581461. Drugs have historically been administered through the ET route or the intravenous (IV) route. cats are OK - You get so much for your dollar here at Vista Verde! WebRVT certification is a credential for medical professionals who want to work in the vascular ultrasound field. You are the leader responsible for key imperatives that enhance employee engagement, while improving operational, financial and clinical outcomes. font-size: .75em;
Select your date and enter your details to start your journey with us we cant wait to meet you. I am asking $450 obo. The guidewire is then advanced beyond the catheter, and the catheter is slid into place over the guidewire (Butterworth et al., 2013; Nagelhout & Plaus, 2014). this hospital bed is in great condition, it will weight the person in it and will tilt the feet up to make it easy for you to move the person up in bed. The catheter should be flushed, or blood should be aspirated into the catheter before removal. If our clinician has questions or disagrees with the prescribing doctor, the clinician will consult with the doctor. It includes 2 batteries and charger, impact drill, driver, hedge trimmer. J Infus Nurs. The use of therapeutic anticoagulation is a relative contraindication, but an antiplatelet agent is not (Theodore, 2020; Weiner et al., 2017). This is generally secondary to multiple cannulation attempts, larger catheter size, and catheter infection (Theodore et al., 2020). PICC Certification and CPUI are trademarks. ESG (Environmental, Social, and Governance), Policies, Guidelines and Statements Center, Overview of vascular access complications, Catheter-related bloodstream infections (CRBSIs), Input your total annual number of CLABSIs, Your estimated financial impact of CLABSIs, Your estimated financial impact of PIVC failure. Since multiple catheter types can cause a CRBSI, the INS advises strict adherence to infection prevention measures during catheter insertion and all catheter management encounters. Call SOPHIE ToDaY! Injectable drugs can lead to severe tissue damage and require amputation of the limb if administered into an artery rather than a vein (Butterworth et al., 2013). PIVs being used for intermittent therapy (i.e., not continuous infusion) should be flushed with 2-10 mL of sterile saline after every medication administration or at least every 4-12 hours (Frank, 2020). PIVs are short-length catheters (under 3 inches or 7.5 cm) intended for short-term therapy. Jobs. You will enjoy access for 180 days from date of purchase, after which you will no longer be able to access the course. Xu and colleagues (2016) found in a retrospective study of 367 patients that midline catheters resulted in more numerous yet less severe (i.e., non-life-threatening) complications than PICC lines, which led to fewer yet more serious complications. The catheter is then advanced over the needle-guidewire before removing the needle-guidewire and securing the catheter. Limited Availability. J Infus Nurs. A decrease in pulse pressure from the patients baseline reflects hypovolemia, decreased stroke volume, or increased systemic vascular resistance, while a relative increase reflects the reverse conditions. Embolism can also occur due to dislodgment of a thrombus at the catheter site leading to extremity ischemia. You are responsible for managing relationships with the vendor whose products help standardize practice and improve clinical outcomes while maintaining your hospital's economic goals. NursingCE.com is a comprehensive online resource to help nurses meet continuing education (CE) and licensing requirements for all 50 states, Washington, D.C. and Guam. 08/27/2010 . This saves money, time, and coordination with a Radiologist or other doctor and enables the lines to be used immediately to avoid delaying treatment. It's important that you research carefully and read over any paperwork you may be asked to sign. Failure to maintain adequate pressure can result in hematoma formation and potential arterial bleeding at the insertion site. Extended-dwell PIVs are instrumental in emergency department settings, as they can be placed at the bedside by specially trained IV nurses (Bahl et al., 2019).