RE: invasive site marking

[Marilyn Patterson]

If we do the insertion immediately after getting the consent (IE without leaving the room) we call the consenting our "time out". If there is an interuption between the consent and the insertion, then we just take a time out to verify (with the patient and family if available) the right procedure is being done for the right patient, and document this. Since we place virtually all PICC's with ultrasound, under direct visualization, we do not generally mark the site. The JACHO standard really is aimed at not amputating the wrong limb. Our QSV department is satisfied this meets the standard, as we don't always know which arm/vein we will cannulate until we get there, assess the patient and veins, etc., so we are allowed to say this is "not applicable" on the QA forms we send them. I like the idea of using a marker to verify length of catheter to insert, thanks for the idea!. We also have available sterile marking pens, the insertion site could be marked with these after the skin prep is done. -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of MidWest Vascular Access Sent: Tuesday, January 10, 2006 8:21 PM To: 'Helen lazeration'; [EMAIL PROTECTED] Subject: RE: invasive site marking Helen,   We do practice in this manner.  When measuring for PICC insertions, we make a mark on the patient’s arm with a black marker on the outer aspect of the arm, the same distance from the axilla as the proposed insertion site.  I want to stress that the mark is not made on the inner aspect of the arm in the area that is cleansed, rather on the outer aspect of the arm.  Once the vessel is cannulated, we compare the distance from the mark to that of the actual cannulation, proximal or distal, and make adjustments in measurement accordingly.   The time-out is a moment to be sure of all the “Rights”.   Michelle Followell, RN, CNN, CRNI   MidWest Vascular Access P.O. Box 7061 Shawnee Mission, KS  66207 913-593-9557 [EMAIL PROTECTED]   -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Helen lazeration Sent: Tuesday, January 10, 2006 9:22 PM To: [EMAIL PROTECTED] Subject: invasive site marking   We have been having discussions as of late at our facility regarding marking PICC, CVC sites prior to procedures and also doing a "time out" for these insertion procedures.  Does anyone out there do this for these type of procedures?   Helen Lazeration, CRNI Fairbanks Memorial Hospital Fairbanks, Alaska __________ NOD32 1.1208 (20050902) Information __________ This message was checked by NOD32 antivirus system. http://www.eset.com