Your interpretation could also be open to differences. I would call
the EJ a peripheral, superficial vein, but I would label the IJ in
the neck as a peripheral deep vein. The IJ moves into the thoracic
cavity when it joins the subclavian vein to become the left and right
innominate or brachiocephalic veins. I would define a central vein as
those located within the thoracic cavity. If that is our definition,
then a subclavian site would be the only real central insertion. The
subclavian is punctured just at the point where it enters the
thoracic cavity. So it looks like we have some work to do on a
consensus of definitions. We could use the central insertion label if
we considered the trunk of the body rather than an extremity as the
defining landmark for "central", but then we must decide what
category to put the neck insertion sites into. Then there is high IJ
and low IJ sites. The more I think about this, the more I see so many
different options! So I think it is time to take a break for
Christmas and think about something besides veins and catheters for a
few days.
I want to wish everyone a very Merry Christmas and Happy New Year and
hope to see everyone at the AVA conference after the holidays! Lynn
At 7:32 AM -0700 12/23/05, Robert Nohavec wrote:
I would agree with most of your comments. However, my interpretation is
not really location of insertion i.e. neck, arms etc... Rather the
system of insertion i.e. peripheral venous systems vs central venous
systems. IJ is central venous system and EJ is peripheral venous
system.
Robert Nohavec RN BSN CNC
University Health Cre
University of Utah
"MidWest Vascular Access" <[EMAIL PROTECTED]> 12/22/2005 8:20:18 PM
If the tip of an intravenous catheter resides in the SVC or IVC, then
it
is a central catheter. But, the site of insertion should determine
whether it is referred to as a Peripherally Inserted Central Catheter
or
a Centrally Inserted Central Catheter (tunneled lines, implanted
ports,
percutaneous triple lumens, dialysis catheters). I have been trained
for years that a line that originates in the neck or chest is a
centrally placed central catheter. A line that starts in the arm, or
legs of peds patients, is a PICC.
If a line manufactured to be a PICC is placed anywhere but the arms or
legs, it is still a central line (if in the vena cava), but should no
longer be called a PICC, rather a percutaneous central catheter.
Please correct me if I am wrong!!!!!!!!!
Michelle Followell, RN, CNN, CRNI
-----Original Message-----
From: Fritz, Donna [mailto:[EMAIL PROTECTED]
Sent: Thursday, December 22, 2005 2:49 PM
To: Betsy Harmon; MidWest Vascular Access; Mullins, Lilia;
[EMAIL PROTECTED]
Subject: RE: question for the group: Neck placements of PICC Lines
Isn't tip termination inherent in the definition of a central venous
catheter?
Donna Fritz
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] Behalf Of Betsy Harmon
Sent: Thursday, December 22, 2005 11:41 AM
To: MidWest Vascular Access; 'Mullins, Lilia'; [EMAIL PROTECTED]
Subject: Re: question for the group: Neck placements of PICC Lines
CDC made the destinction that the EJ is peripheral and the IJ is
Central.
Betsy Harmon RN BSN CRNI
----- Original Message -----
From: MidWest Vascular Access <mailto:[EMAIL PROTECTED]>
To: 'Mullins, <mailto:[EMAIL PROTECTED]> Lilia' ; 'Betsy
Harmon' <mailto:[EMAIL PROTECTED]> ; [EMAIL PROTECTED]
Sent: Wednesday, December 21, 2005 4:59 PM
Subject: RE: question for the group: Neck placements of PICC Lines
A PICC placed in the neck. well, is not a PICC, but a percutaneous
central line that is not peripherally placed. Am I right?
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Mullins, Lilia
Sent: Wednesday, December 21, 2005 1:31 PM
To: Betsy Harmon; [EMAIL PROTECTED]
Subject: RE: question for the group: Neck placements of PICC Lines
Please share with the group, what about Nurse Practice statements?
Thanks in advance
Lilia Mullins, RN, CRNI
Swedish Medical Center
Seattle, WA
_____
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Betsy Harmon
Sent: Wednesday, December 21, 2005 10:26 AM
To: [EMAIL PROTECTED]
Subject: question for the group: Neck placements of PICC Lines
I have heard that some of the PICC Inserters out there are placing
PICC's in the EJ. If so would you be willing to share what type of
documentation your facility requires for that placement. Is there any
competencies required? Do you have to document educational experience
for placing PICC's in the neck. Anything you have would be
appreciated.
Please e-mail me with any info.
Thanks in advance.
Betsy Harmon RN BSN CRNI
Vascular Access Team
Critical Care Unit
Alaska Native Medical Center
Anchorage, Alaska 99508
[EMAIL PROTECTED]
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Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
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http://www.hadawayassociates.com
office 770-358-7861
