Checking email status.....Have not received a email in quite a few days. -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Lynn Hadaway Sent: Wednesday, November 09, 2005 7:03 PM To: Tim Talbert; [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: Re: SV: PICC Removal Dressings
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 >this message may be privileged and confidential >and protected from disclosure. -- 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
