Sorry Kathy but there have been numerous places monitoring this by
clinical signs and symptoms. When a patient complains of hearing a
running stream or a gurgling sound, this is a classic sign that the
tip is in the IJ and time to get an xray. I would agree that there
are no recommendations for a specific frequency of repeat chest xray
to determine tip location because no studies have established what
that interval should be. I personally think this would be very hard
to to as tip movement with all types of CVCs is a sporadic thing
usually due to changes in intrathoracic pressure. Lynn
At 6:54 AM -0700 11/7/05, Kokotis, Kathy wrote:
Do you think this would have happened with all central lines. I do.
I do not know the answer except that we never monitored this before
kathy
________________________________
From: [EMAIL PROTECTED] on behalf of Scott Gilbert
Sent: Wed 11/2/2005 10:26 PM
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: Flipping PICC Loops
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?
--
Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
