I don't know if the supervising physician is normally present when the nurse performs these procedures, but if so he should have noticed the difference between a 3cc and a 20cc syringe, I would have thought.
Not using a hypodermic more than once without sterilizing or discarding it is something that even most laymen would know, let along a trained nurse. This does seem likely to be criminal negligence to me.
The only thing I want to see in a 20 mL syringe that is being put in the ol' heparin lock is that lovely Demerol cocktail they gave me in the ER after an auto accident...
Mmmmm....demerol... :P~~~~~~~~~~~~~~~~ (homer simpson drool)
{quote}I don't know if the supervising physician is normally present when the nurse performs these procedures, but if so he should have noticed the difference between a 3cc and a 20cc syringe, I would have thought.
{/quote}
A couple of points:
The size of the syringe has nothing to do with anything. There is no "standard size" syringe used for anything, though most will choose a syringe that most closely apprximates the anticipated volume of medication administered.
Second, as an Anesthesiologist and Pain Management Physician who is still practicing (though I do my own sedations for pain procedures IF it is required), I can tell you that seeing what the CRNA is doing in FRONT of the patient (i.e. the manner of injecting medications in an IV-heplock) may be impossible while you are sitting/standing BEHIND the patient performing the pain block.
Third, Nurse-Anesthetist's (CRNAs) are lobbying a lot of states, to "opt-out" of the Physician supervision requirements over CRNA's, after receiving a last minute Clinton Administration Executive Order in their favor (since softened to some degree by the Bush Admin). In some states CRNA's are not required to be supervised at all, which is scary to say the least. You can find the ASA's opinion about this here at :
http://www.asahq.org/Washington/opposing.pdf
Fourth, it is criminal negligence to re-use needles on different patients...at least in a reasonable world. Every health care provider SHOULD know this is not acceptable and carries extreme risk.
Then again, every cigarette smoker SHOULD know the risks of smoking by now, but some manage to successfully claim ignorance to the tune of BILLIONS of dollars in settlements...