There is evidence of a skin to vein tract when a
catheter is removed. There is evidence that a
fibrin sheath is present on virtually all
catheters and that it stabilizes with collagen
and smooth muscle over time. So it is possible
that an air emboli would have a potential route
into the bloodstream. I am not aware of an actual
published report of an air emboli from a PICC
insertion site after it has been removed. Absence
of evidence does ***not*** equal evidence of
absence. Therefore all precautionary
interventions should be taken. Lynn
At 4:11 PM -0800 11/9/05, Tim Talbert wrote:
Any evidence for this statement or is it opinion?
Tim
"Lynn Hadaway" <[EMAIL PROTECTED]> 11/9/05 >>>
The risk of air emboli from a site where a PICC
has been removed is minimal, but it does exists.
There will be a skin tract left when the PICC is
removed. There could also be a stabilized fibrin
sheath acting as a conduit of air into the
bloodstream. I have never heard of an AE
happening from a PICC removal, but it could
happen. The INS standards of practice includes
PICCs in the standard for applying an ointment
based dressing to the site when removing. Lynn
At 7:16 PM +0100 11/9/05, Mats Strömberg wrote:
Lynn,
Is the report you mention on a PICCs? I don't
think anyone puts ointment on the puncture site
in Sweden. Bard here certainly does not teach it
and I have never heard about any patient
experiencing air embolus after PICC removal.
Has anyone on the list experienced a patient
with air embolus after PICC removal?
Den 05-11-09 17.43, skrev "Lynn Hadaway" <[EMAIL PROTECTED]>:
I am convinced that an ointment-based dressing
is required to adequately seal off the puncture
site from any CVC. There will always be a tract
from the skin to the vein. It is true that the
risk of air emboli is greater with a subclavian
or jugular site but I would also write my policy
to place the same dressing on PICCs for
consistency of practice and to be extra safe.
This has been discussed in critical care
literature also as the best practice. An air
emboli have been reported when this was not
done. I have worked in several hospitals that
did this as routine procedure. Lynn
At 10:52 AM -0500 11/9/05, [EMAIL PROTECTED] wrote:
Our institution currently doesn't have a policy
that states to put an oil based dressing on
after the removal of a PICC line. Even more,
they are not currently doing so for the removal
of a Triple Lumen Line. I know that the INS
states that there should be a oil based dressing
placed over the exit site...however, is this
truly best practice? What are others out there
doing?
Lorelle Wuerz BS, RN
--
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
Notice from St.Joseph Health System:
Please note that the information contained in
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--
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
