If the patient is able to answer questions inquire if the patient is experiencing chills. Elderly or immunosuppressed patients may remain afebrile. The recommendation is to draw blood cultures, one from the PICC and one peripheral.
Yes I have seen patients who are asymptomatic but with positive blood cultures. Wendy Boersma, RN, BSN, CRNI Throughput and PICC Services Manager 269-966-8591 or pager 269-410-0385 This message may contain confidential information protected by law through attorney-client privilege or professional peer review/quality evaluation privilege. It is intended only for the individual or entity named above. It is prohibited for anyone else to disclose, copy, distribute or use the contents of this message. If you received this message in error, please notify the BCHS Privacy/Integrity Office at [EMAIL PROTECTED] or (269)966-8017. >>> <[EMAIL PROTECTED]> 12/28/2005 7:25 AM >>> It would seem to me there are a couple of other sources here other than the PICC. the sputum growing funky stuff? The abd tenderness..... It is good they are waiting to pull the PICC. Itshould be included in the investigation -- how long has the PICC been in? Jose Quoting Betsy Harmon <[EMAIL PROTECTED]>: > New question for the group. > > Had a physician today ask if I had ever heard of a patient having an infected > CVC or PICC but was totally asymptomatic? No erythema, tenderness, drainage, > etc at the insertion site of up the extremity for a PICC. No other symptoms > except for a high WBC? > > CT of head chest and abd done today on patient > Blood cultures pending > Sputum cultures growing lots of funky stuff. No CXR ordered since 10/13/05 > UA sent for culture and sensitivity pending > Pt has partial Bowel obstruction. Has g-tube, and severe abd tenderness > PICC site soft, non-tender complete up inner aspect of arm to axilla when > palpated. No increase in arm circumference, no increase in forarm > circumference. No pain across anterior chest, both lumens flush like a > dream. No erythema, drainage or swelling at insertion site. > Physicians want to pull the PICC for suspected infection source. Any help to > the two questions posed in the first paragraph? I have asked enough > questions about the patient they are waiting until something really indicates > the PICC as the source. We do not do "time to positivity" cultures yet at > our facility, the lab is looking into this for me. > > Thanks in advance. > > Betsy Harmon RN BSN CRNI > Vascular Access Team > Critical Care Unit > Alaska Native Medical Center > Anchorage, Alaska > [EMAIL PROTECTED] > > > > >
