we also have cases of piccs migrated out of the SVC,
both peds and adults: up the IJ, back loop to the same
side of the SC, into azygos, loop into the opposite
site of the SC/brachialcephalic -- all with right arm
placement.
--- Leigh Ann Bowe-geddes <[EMAIL PROTECTED]> wrote:
> Scott:
> I saw two well placed PICCs this week that migrated
> to unusual
> positions. One flipped up just at the tip, with the
> end of the catheter
> pointing upward. This resolved with flushing and
> sitting the pt up. The
> other was in good position for three days, then
> migrated to the azygos.
> I left that hospital before the repeat x-ray came
> back on it, but we
> positioned that pt on his right side and flushed,
> then sat him up for a
> while. I expected this one to reposition also, and
> didn't hear that this
> trick didn't work.
> In our facility we had a pt with a PICC in lower
> SVC, but it kept
> flipping up to the IJ. He was on a high frequency
> vent, so we thought
> that may have been the reason for this problem.
> Leigh Ann
>
> Leigh Ann Bowe-Geddes, RN, CRNI
> IV Therapy Specialist
> Infusion Services Department
> University of Louisville Hospital
> Louisville, KY
> 502-562-3530
>
> >>> "Scott Gilbert" <[EMAIL PROTECTED]> 11/03/05
> 12:26 AM >>>
>
> Just wanted to see if others have noted any
> situations of well placed
> PICCs that have looped upward at a later date.
> Migration of tip has
> been discussed before. What we have noted is that
> ventilated
> patients, those who get regular (hourly) bed
> generated back percussions,
> or chest compressions during Codes have tossed a
> PICC upward towrd the
> jugular. Recently two patients (on ventilators)
> with PICCs within 2
> days of good placement (caval atrial 5FR DL Poly)
> following several
> thumping episodes on special bed vibrators have had
> PICCs loop upward
> (still tip pointing downward) into the IJ. And they
> remained stuck
> upward (not falling afer 24 hours) until pulled or
> replaced. On one of
> the patients it happened with the second PICC also !
>
>
> Any similar incidents?
>
>
>
>
>
>
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