The pt needs a venogram to determine his patent vasculature and potential sites for access. Angio would be able to place a line in any open vessel, and tunnel the exit point to somewhere on the skin, but need to know what is open, and where it goes. Under no circumstances should someone place a bedside picc using just US on this pt. In that much I agree with Mayo. Sandy Schwaner Rn Angio/Interventional Radiology University of virginia Charlottesville
________________________________ From: [EMAIL PROTECTED] on behalf of Monica Sorg Sent: Mon 1/23/2006 6:19 PM To: [EMAIL PROTECTED] 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 This message, including any attachments, is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law, including PHI (Protected Health Information) covered under the Health Insurance Portability and Accountability Act (HIPAA) of 1996. 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.
