Re: need suggestions

[Gwen Irwin]

We had a patient in a similar situation.  He had a port implanted that accessed the femoral vein.  It made for more difficult access than usual.  I used a 1 1/4" access needle when having him do the Valsalva manuever.  Other options would be to consult the interventional radiologist for access sites.   Gwen Irwin Austin, Texas ----- Original Message ----- From: Monica Sorg To: [EMAIL PROTECTED] Sent: Monday, January 23, 2006 5:19 PM Subject: need suggestions Hi all,   I have a patient that the vascular radiologist was unable to get a quad on today.  Only after that did the family tell the ordering doc that a recent ultrasound at another hospital apparantly showed significant thrombosis in the vasculature of the chest veins.  We are requesting those results from that hospital.  He has a history of thrombosis with any central access he has ever had, including a tunnelled line to the subclavian, as well as a PICC in the left arm.  He tells me that they told him at the Mayo Clinic that the left arm is never to be stuck again for any reason.  Alot of heresay, I know.  If we can't get recent relevant info, I'm going to ask for an ultrasound of that arm as well as the subclavians, axillary, etc.  My question is, what now?  This guy is a bone marrow transplant patient with a definite need for central access (Vanc, IV Bactrim, KCL runs, Mag, and more).  A tunnelled femoral port is being considered.  I'm at a loss as to how to advise in this case.  Any suggestions would be appreciated.      Monica Sorg, RN CRNI Infusion Nurse Specialist University of Louisville Hospital Louisville, KY ----------------------------------------------------- Confidentiality Disclaimer   If you are not the intended recipient(s), you are notified that the dissemination, distribution, or copying of this message is strictly prohibited.  If you receive this message in error, or are not the named recipient(s), please notify the sender or contact the University of Louisville Health Care I.S. helpdesk at 502.562.3637 to report an inadvertently received message. -----------------------------------------------------