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crash
10-21-2007, 13:25
WAMC has changed from the Insyte Autoguard's to BD Nexiva, closed IV catheter system.
Was just wondering if anyone here was using them and what their opinion of them is?


http://www.bd.com/infusion/products/nexiva/

Here's my opinion of the new needle's...
If you go to the link and 'Features and Benefits' I'll go through it by the numbers.

1-Needle has more of a bevel, I don't like this. You no longer feel the pop you did with other needles and there is more room for error in having only the tip on the needle in the vein and trying to advance the catheter.(this has happened quite often since we got these)

2- According to BD's Rep the actual catheter is the same as their other needle's but they seem to kink more often, although this could be because of the bevel and improper placement.

3-Stabilization device (Wings) This is nice it keeps the catheter more secure, very nice during a trauma when your in a hurry. EMS has had a few issues with the wings with IVs in odd places, usually just us a 2x2, 4x4 under the wings for support.

4- Insta-Flash, the needle has a 'window' instead of a flash chamber.
I like this, you can tell if you've gone through a vein or not by whether the blood is still flowing into the tubing; doesn't help if the tubes already full or if you've placed the hep-lock on already.

5- Needle shield, BD wanted a passive system, because a lot of people wouldn't press the button on the Autoguards. The shield is bulky, and the way it cleans the needle is with a little squeegee that offers resistance when advancing the catheter/removing the needle. Makes it feel as though its not in the vein at all, and it requires both hands to advance. Also the needle tends to get stuck if not pulled straight back, requires a little jiggling to have it separate from the catheter. Its also not fully enclosed like the Autoguard.

6-Ergonomic grip, yeah its nice, and the finger tab for advancing, but as mentioned above it requires a little bit of force to advance. Not something I've found works well one handed.

7-Clamp Also takes a fair amount of force, and both hands to operate, BD rep says their working on a different type of clamp.

8-extension tubing, made to take the place of the extension set, although about 85% of nurses still put one on.

9-Dual port lumen, very nice.

10-Q-syte leur, these are nice they close from the inside out, in theory pushing dirt out, unlike the old ones where you had to put on a cap, and dirt could get inside.

11- vent plug, not so nice as some people don't flush and put the other leur on, and this cap could come off and a pt could bleed out(in theory), also EMS doesn't like the having a second leur, as they could loose it. However the tubing would not fill with out this vent. I wonder if a vent could be made into the lumen without compromising it.


In the end their not that bad, takes a little getting used to; the firmness of removing the needle makes it hard sometime, especially kids where you might be trying to hold them with your other hand. Its a good start, I like the idea behind a closed system, but then again once you get good at it you don't really make a pt bleed with the old system.

Well hope this helps someone, if anyone would like to give these a try just let me know. Would like to hear others opinions of these as well.

I'm sure the BD rep would supply a couple boxes if someone wanted to give them a try. They loved our feedback, sure they wouldn't mind more.
Can't wait to see what their next version is.

Surgicalcric
10-21-2007, 17:01
I am more of an Auto-guard guy myself...

When I was on SOCM rotation these were introduced into TGH for trials. They sucked then (for the reasons you mentioned) and it appears they havent made any improvements.

Crip

crash
10-21-2007, 17:05
I prefer the Autoguard's too; but we don't have a choice.

tmill
11-20-2007, 19:34
Gentleman, as mentioned earlier, the catheter system is not practical for EMS or field use. I tried the sysem in EMS(pilot program) and in Africa. The catheter is too "busy" and is not condusive to fast insertion. The perfered method still remains the old catheter over needle stainless hub, or the angiocath. I prefer down and dirty, keep it simple.
Tmill

crash
09-01-2008, 22:56
Gentleman, as mentioned earlier, the catheter system is not practical for EMS or field use. I tried the sysem in EMS(pilot program) and in Africa. The catheter is too "busy" and is not condusive to fast insertion. The perfered method still remains the old catheter over needle stainless hub, or the angiocath. I prefer down and dirty, keep it simple.
Tmill

Been using these awhile now and have to say they have grown on me. They make fishing alot easier with being able to have a flow and not just the flash.
Which really just makes for less pain for the pt; as well as less blood exposure for me.

Now as far as field use, it doesn't really matter if the pt hurts or bleeds if hes alread been injured; and the autoguards are so much faster.

So these are fine for the hospital but I wouldn't use them in the field, maybe carry a few small guage ones incase I had an elderly pt or something along those lines.