I would agree that tip location is a critical piece of
information. But I really do not understand why some feel the need to
use a catheter designed as a PICC for insertion into the jugular vein
anyway. Also one other point is that this catheter will usually have
"PICC" stamped on the external catheter, so this will be
other source of confusion when inserted into the EJ. Lynn
At 10:28 AM -0500 12/23/05, Martha Pike wrote:
Again - a plea to always use terminology that clearly identifies where the line is located as well as whether it has a central or peripheral tip location.
The distinction re whether this device went in through the internal or external jugular influences the comparative risks during the insertion procedure, but is of little consequence in terms of caring for the catheter afterward. If both are threaded to the SVC, both are central lines. If both are inserted in the neck, then there are the same problems / issues with nursing care.
However, the difference between an antecubital or upper arm insertion and an insertion in the neck is of great consequence in terms of caring for the catheter and making sure that all nurses in all subsequent post hospital care situations understand what kind of admission they are accepting so that they can ensure that the patient receives competent and safe care.
PICC is a term that has been well understood for almost 30 years to be a device that is inserted through the arm. To call an external jugular device a PICC without identifying the point of entry creates great confusion.
My personal preference would be to call it a jugular CVC as that is how it will be cared for. However, if we need to call it a PICC to make it clear to Boards of Nursing that it is OK for a nurse to insert, I don't object as long as we say - consistently every time we discuss it or document care - that it's a jugular PICC.
/Martha - Boston
On Dec 22, 2005, at 10:20 PM, MidWest Vascular Access wrote:
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]]On 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 distinction that the EJ is peripheral and the IJ is Central.
Betsy Harmon RN BSN CRNI
----- Original Message -----
From: MidWest Vascular Access
To: 'Mullins, Lilia' ; 'Betsy Harmon' ; [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 neckĀ 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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office 770-358-7861
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
