Prompted by an experience last year in which I was told they’d do a second IV once I got to the OR.
When I woke up, I had two badly bruised spots, bandaged, in my right hand, and a second IV in my left hand (same hand as the first). In other words, they tried to do the IV, twice, and failed, and resorted to the other hand. While I’m not the easiest stick, the initial IV in pre-op went in just fine - but by the time surgery came around (delayed 4+ hours) I was very dehydrated. It’s no surprise they had trouble.
And, annoyingly, the surgical report said “got it in one try”. I actually asked the doctor “so that’s clearly false, what else did they lie about?”.
Anyway: I absolutely get the reason for having a second IV - you want access there in case the first one fails and there’s an emergency. I have zero issues with that.
But why on earth wait until the OR to do it? Why not do it up front, where the patient is still relatively well hydrated and you’ve got plenty of time, versus expensive OR time??
I’ve got another surgery coming up where I imagine the same thing will apply and I’m trying to decide how bratty I need to be about insisting that they establish the second IV when I’m still awake. Blood thinners were involved last year and will be this year as well.
Maybe the second IV is not used unless an emergency develops. Or only for some thing required during the operation. Also they know that you are definitely being operated on if they install it after you are on the table and under. If they install it before that point, the operation may be delayed and you have the annoyance of an IV that is capped off and may have to be removed if the delay is long.
Just a couple of guesses.
I have had a few major surgeries. With lots of IV’s. Easy on my left side. Difficult on my right side.
Maybe he wasn’t the first person to try? I once lost so much blood from a gastric bleed, three different people tried before they got a successful IV in.
It was in place - and they gave me a bolus when I first arrived, but not left running. Then surgery was delayed by 4+ hours so it had been about 6 hours since that bolus. I’d been about to demand that they turn it back on when the crew finally came for me.
There was a bag, but the valve or whatever was turned off. I wish it had just been the cannula - I had to drag that thing to the bathroom numerous times.
I’m pretty sure it’s not routinely used, and I think it’s a good idea to have it in place BEFORE it’s needed. Of course, if the issue was the concern over the delay, that would apply to the original one as well.
Someone on a support group posted that she actually wound up with an ARTERIAL line placed during surgery. I get the sense that THAT wasn’t planned.
Was the second (OR) IV placed before or after you were placed under anesthesia? Perhaps they wanted to spare you the annoyance of being poked more than once while conscious (although that did not happen).
I find IV really restrictive, and being pinned down on both sides would be materially worse. And would cause the same kind of problems for people who are trying to reach aroumd me, or move me, in theatre.
Still, if you want to have two IV’s in while you wait, talk to the staff. It may be that your surgeon and anaesthetist won’t object.
It was after I was out - the only way I knew was because I had the two bandaged spots on my right hand, and a second IV in the left hand.
I’d have been happy to have them start it in pre-op, much earlier. I would have fought whomever was doing it, if they took that many tries while I was conscious. Not fought, really, but my attitute is you get one try in a spot, no wiggling the needle. You try in another spot. And if that fails, you get someone else. This time, of course I couldnt defend myself.
They may have wanted an IV line which can administer a larger volume of liquid (than the first IV) during the surgery. Starting this would require a larger needle than normal and thus cause a larger amount of pain than normal so they wait until your under anesthetic to administer it.
I had to have some blood taken earlier this week. The tech was a nice, chatty young guy, which I found unusual, because the techs there are all unsmiling middle-aged Russian women. He poked me once, wiggled around inside, and took the needle out with an apology. Then he tried my other arm, poked me, wiggled, took the needle out, apologized. He went away for a moment, then led me to a different curtain, where an unsmiling middle-aged Russian women got it on her first try and sent me on my way with a dour expression.
Some medications are incompatible with each other.
Sometimes the lines get blocked or kinked and stop working. A backup avoids delays.
If fluids or blood need to be given quickly, two lines double the speed of administration.
Sometimes continuous drips are given for pain relief, to maintain anesthesia, to treat blood pressure changes or for emergencies (many; say postpartum bleeding requires bloood and syntocinon). These monopolize lines, making another line helpful.
It can be tougher to get access during emergency situations, such as if a complication lowered the blood pressure. Do it when it is easy. This can be more so in elderly or podiatrist patients, or those with diabetes or vascular disease.
The drawbacks of putting in an IV and not needing it are relatively mild, and IV lines are inexpensive. They can also be used to draw bloodwork.
As “the standard of care”, in the event of any difficulty not having a second line would be criticized.
