To refuse an IV?

[Teaandflapjacks]

Have also posted this in childbirth...

Is it possible to refuse this do you think - and if so would that be daft of me? I have recently come out of hospital after going into early stage labour too soon with a short cervix - which has now calmed down and nearly at 36 weeks so not an issue now - and they put the thing in my hand 'just in case' and took some blood from it, but no fluids or meds went in it as i was able to swallow tablets. When they put it in I didn't think to question it. It was agony, could not sleep the whole night from it there and begged them the next day to take it out, which they did after the consultant said it was OK after me begging him. Then my whole wrist and half my hand slowly turned blue and black, plus the vein in my elbow fold went dark black - so I am sure it wasn't put in right. Now I am terrified of the ruddy things (and I have a high pain thresh hold normally...!).

[izchaz]

The thing they put in your hand is called a Venflon, it's standard procedure to fit them to anyone HCP expect to take regular samples from or who may need additional fluids or liquid medicines. The fact that yours was even faintly sore tells me instantly that it was poorly installed - you shouldn't be able to feel it unless you touch it. Yours sounds like it had perforated the back of the vein, hence the pain and excessive bruising. Please don't be scared of them, they are incredibly useful, very safe when correctly installed, and can be a life saver in crash situations. When you next come to have one installed (in pregnancy or otherwise) explain that you have had a very poor previous installation and that you are wary of them, this should ensure the practitioner takes extra care to put it in right. Beyond that, if it is sore AT ALL request that it be re-sited, as it is touching or perforating the back of the vein. They should be re-sited every 72 hours anyway in order to prevent damage to the skin at the sight and reduce risk of infection and clots forming on the needle. Knowledge is your friend, don't be scared of them, do your research and ask questions of your HCPs if you're not sure of anything.
HTH

[Bunnylion]

Great advice above. Just wanted to add - you are 100% free to refuse anything the hospital want to do to you, it's your body.

I'm sure, as the above poster said, they'll put it in properly next time and it won't be an issue but do ask them what the alternatives are and weigh it up then before you agree to them putting it in again.

[CheeseFondueRocks]

Where I am, they don't put a venflon in at all when you go to hospital in labour. Only if you are being induced or need other regular testing/drugs.

Sadly, I will need one this time as I'll need IV antibiotics in labour. I'm very upset about this as it will restrict my water birth.

So, unless you need a venflon, of course you can ask not to have one. There is o examination/procedure the hospital can do without your permission.

[workingtitle]

You can refuse a cannula, absolutely. These are often put in 'just in case' but as it takes no time at all to put one in, so I would just say you will wait and they can do if/when there is a clear clinical need for it (with your consent!).

[rallytog1]

My understanding is that they should only hurt or bruise if they're used for a blood transfusion. When I had DD I had a canula in each arm - one for antibiotics and syntocinon and the other for fluids and blood transfusion (long story - it's unusual to have this much going in!).

The one with antibiotics didn't hurt at all but the transfusion one had an amazing bruise which didn't go down for several weeks. It didn't really hurt, although the morphine may have had something to do with that! So it sounds as though there was something very wrong with how yours was put in.

[Teaandflapjacks]

Ahh thanks ladies - and massive thanks to izchaz as that is really helpful. I was sure something was wrong with it at the time and did question it - but this was in germany and my german, whilst good, isn't fluent so I think they just kind of smiled and got on with sorting the other things out. My hand is still bruised a week and a half later - although way less. Anyway, I will do what you have kindly suggested and make sure it's a more experienced person doing (I got a midwife who was roughly 25 years old - I think she was probably just inexperienced - nothing at all wrong with that, we all have to learn somewhere!). xx

[woollysocksaresexy]

As all the other posters say, there was something wrong with that one. What I find handy (and what they do for kiddies) is to ask them to tape it down properly and put a bandage round it, especially if there are bits attatched to it and flapping around as these easily get caught on things and knock the cannula, causing pain and discomfort, and make it more likely to get dislodged.

[izchaz]

Glad to have helped OP. I see some atrocious installations done by FY1 (baby/trainee/dont-know-arse-from-elbow) doctors on the wards I work on, it makes me shudder, because I know how bloody sore they can be when done poorly. You have to have to be your own advocate in health care settings, as a health care professional I also have a duty to advocate for you if you're in my care (or not, on occasion), but your voice will carry more weight than mine because it's YOUR body. Ask, demand, make a fuss if you're not being listened to, get any companions with you to also kick up stink because sometimes we as professionals miss things, do things wrong, botch things or are thoughtless. We try, but at the end of a 13 hour shift we are eminently human!
Good luck for the rest of your pregnancy, labour and future run-ins with the medical world.

[izchaz]

And woolysocks makes an excellent suggestion there, it's often what is done for very confused or forgetful patients in order to protect a site, it's no bother, so request it if you think you're likely to snag it whilst moving about (it should really be taped as par for the course, but bandaging gives an added layer of protection).

[izchaz]

Another thought (I'm on a roll here...) when the venflon is removed for discharge/end of therapy/re-siting press hard on the site for at least 5 minutes, as this should reduce the bruising - same goes for any blood sample sites. Pressure helps the wee puncture in the vein to seal well, reducing blood loss into the surrounding tissue, thusly less bruising.

[Teaandflapjacks]

Actually mine wasn't taped down that well either, and they put a stretchy bit of what looks a bit like a white hair net (sorry for medical knowledge on what that was!) around it and I suppose that probably didn't help. I also was instructed by the midwife just to hold the spot where she took it out for a minute, then she took the cotton wool off me and then strapped me up to the ECG machine to check the babies heart and my contractions for half an hour - I think it was a bad combo of events - but good job it was like this for the 'trial run' I had, and i have had some really great tips now ahead on here which will def be doing when the little princess deigns to make her appearance!

So huge thanks again x

[badguider]

Can I just butt in to ask what the difference is between a 'cannula' and a 'venflon'?

I have had what I think was a cannula in the back of my hand once before and I was told to get dressed with it still in and it was HORRIBLE - I really couldn't flex my wrist without it hurting and it really really limited my movement. I was planning to refuse in labour unless totally necessary as for example there's no way I could go down on all fours with it in - the act of bending my hand to 90deg with my forearm (as when you're on all fours) made the needle jab in somewhere inside my hand.

I am assuming (maybe wrongly?) that if I'm well enough to have an active labour and be on all fours and moving around like that then I probably won't also be needing the needle in my hand? Is that stupidly naive?

[MortifiedAdams]

Cheese are you still able to have a waterbirth? I have to have the ABs this time but want a water birth.

[Teaandflapjacks]

I think bad it is one and the same thing. But I think the best place is meant to be on your wrist? another medical person would know better. You basically are asking what i thought too - I think from what i got back (have a look on Childbirth because I posted the same Q in there, and got some other advice that is also really helpful) that they do it as standard. But you can just check with your hospital up front?

[FraggleRock77]

I feel exactly the same. I recently had to have one in my hand over night and it was sooo painful. I asked for pain relief the whole, which is totally pathetic but they really hurt, plus my veins are small and rubbish

[Jojo3737]

I have a phobia of needles and was really frightened when they planned to induce me and put a cannula in (luckily my DS2 arrived on his own 2 days before my induction date), my consultant was lovely, showed me how they would insert it etc.
She advised using a numbing cream on the site before inserting the cannula, taping it down and bandaging my hand. Maybe the numbing cream and bandaging might help?
I also have very thin veins and whenever I had blood taken would result in very sore bruises, they now use a thin child's needle and I don't get as much bruising. Maybe you have thin veins too and need a thinner needle/cannula?

[badguider]

Have just read your other thread flapjacks and have to say I'm not impressed by the 'just suck it up and put up with it' attitude of other posters... i mean in that case why bother expressing any preferences in labour?

I've just checked with the nhs scotland website and it seems they're only standard with epidurals. As I hope to go to the MLU where there aren't epidurals that's really reassured me.

If I do have complications and have to transfer and then be confined to bed i'm not so worried about the cannula as I won't be moving around much anyway.

[Jollyb]

'Venflon' is the tradename for a commonly used type of cannula - so they are basically the same thing.

I

[izchaz]

Jollyb is right, Venflon is the tradename for a Teflon pvc (peripheral venous catheter). A PVC is technically the name of the unit installed in your hand/forearm/elbow-pit/foot/ankle, but they are generally referred to as venflons, on the basis (I think) that the NHS only uses venflon, rather than another brand. Canula simply means "hole" if I remember my Latin right, or maybe puncture... anyway, a canula can be use to describe any medical device that intervenes to provide a small aperture of access, so if you've ever had oxygen through nasal prongs you've had a nasal canula.

[vj32]

I would refuse one if it is being put in 'just in case' - I hate needles and have had horrible experiences with numerous bad attempts to take blood or get a cannula in. I refused a blood test just after having DS as they said I thought I might need a transfusion or fluids. I felt fine, so refused. A midwife hassled me, (as it is her job to do!) a Dr said I could refuse if I wanted.

But: I had a cannula in for my emcs for DS, and for about 12 hours afterwards. To be honest I was too much in pain/out of it on pain killers to notice, and by the time I was really with it, they were taking it out.

I had it written onto my notes by a not hugely friendly Dr that I was needle phobic. I also wrote on my 'birth plan' (ha ha) not to bring a needle anywhere near me unless DH was in the room. I think that my dislike of needles was taken more seriously as it was in my notes.