We occasionally have the same problem with tip locations - the lead radiology tech does the initial read of the film and calls us and we give the "OK to use" order to the staff nurse. What we have happen is we place a PICC very easily, threads easily the whole distance, no problems - and then they call and say it's in the axilla or subclavian vein and to replace it. OK - so where is the rest of the catheter we inserted!? They are not pleased when we ask them to redo the xray, but we have held firm and every single time, the second xray shows in the SVC. Rarely the radiologist will follow-up when they read the film and call us if they disagree with the lead tech's read. We now have a computer xray system so we can actually pull up the film ourselves and look at the film. We are often more accurate than the techs.
Wendy Erickson Luther Midelfort - Mayo Health System Eau Claire WI -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of James N Wilken Sent: Friday, January 06, 2006 10:37 AM To: [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: Determining PICC Tip Location Hi Sarah, When you say that you only place the lines and do not follow them after placement, does this mean that you do not follow up for confirmation of tip placement? And if not, who does? Our radiologists have indicated to us that they will provide a hard copy for the chart of their findings re PICC tip placement within 48 hours of reading same and so the residents are releasing the PICCs for use. Sometimes we are asked to pull the line back only to find out afterwards that it was in a good position prior to pulling back and ends up in less than optimum location. What are others doing for tip determination? Any suggestions? Patrice Wilken Vascular Access Team Winnipeg, Manitoba ----- Original Message ----- From: [EMAIL PROTECTED] To: [EMAIL PROTECTED] ; [EMAIL PROTECTED] Sent: Thursday, January 05, 2006 4:07 PM Subject: Re: PICC insertions I work in a 140 bed community hospital. I have a total of 5 nurses (counting myself) that place PICC lines. All of my nurses are also chemotherapy trained. We work out of an outpt infusion service department. We are open 8-4:30. Our lines are not pre-scheduled, we just fit them into our schedule. Gets a little hectic on Fridays at 3pm. We have 8 hr wkend and holiday on-call coverage. We use MST/US for placement. We don't have IR who place lines, but they will help reposition under fluoro if we have a difficult placement. We only place the lines, we do not follow them after placement. Sarah Jones RN, BSN, OCN, CRNI Oncology Nurse Clinician/Infusion Services Coordinator Upper Valley Medical Center T: (937) 440-4827 [EMAIL PROTECTED] Sent by: [EMAIL PROTECTED] 01/05/2006 04:31 PM To: [EMAIL PROTECTED] cc: Subject: PICC insertions We are an approximately 250 bed community hospital At present, the PICC lines inserted at our facility are done by one of four individuals that comprise our PICC team That team is two Nurse Managers who were willing to take this on as an additional duty, and two RNs employed to provide Nutritional Support Services (follow all central access devises, monitor tube fed patients). We provide service M-F 08-430. My question is, what do other facilities this size and type do to provide PICC insertion services? Do you contract to an IV company? Use Interventional Radiology? Dedicated team? Thanks in advance for any information you can provide. Lisa Kasten Lisa Kasten RN, MSN, CNA, BC Nurse Manager Med/Onc Memorial Hospital [EMAIL PROTECTED] ********************Confidentiality Notice******************** This message is intended for the sole use of the individual and entity to whom it is addressed, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. Any unauthorized review, use, disclosure or distribution of this email message, including any attachment, is prohibited. If you are not the intended recipient, please advise the sender by reply email and destroy all copies of the original message. Thank you.
