|
Ditto. Well said! Kudos!
Heather Nichols RN BSN CRNI
Infusion Services University of Louisville Trauma Institute 530 S. Jackson St. Lou. Ky. 40202 (502)562-3530 >>> "Leigh Ann Bowe-geddes" <[EMAIL PROTECTED]> 02/04/06 8:39 AM >>> While it does occasionally happen that a fibrin sheath completely covers a line and causes retrograde flow of the solution, I have seen chemical phlebitis be a more common cause of retrograde flow when the line is a midline. There are very few medications that can safely be administered via midline without causing phlebitis. The inflammation can cause the path of least resistance (or the only available path) to be retrograde. Make sure that you are choosing wisely when placing a midline. Like you, Nancy, we have essentially stopped placing midlines. It is too rare in our circumstances that the infusate is appropriate.
Another important point may be to stop placing dual lumen midlines. The blood flow at the point of tip termination is not adequate to properly dilute two different medications, particularly if these meds are not compatible with one another.
Leigh Ann
Leigh Ann Bowe-Geddes, RN, CRNI
IV Therapy Specialist Infusion Services Department University of Louisville Hospital Louisville, KY 502-562-3530 >>> <[EMAIL PROTECTED]> 02/03/06 9:36 PM >>> Nancy,
It happens occasionally to me also. But, it can also happen with PICC lines. The catheter is has developed a fibrin sheath. The sheath completely covers the catheter. The fluid runs through the catheter and into the sheath and with no where to go it comes back down the cathter. At least this is my deduction from many years of experiencing this phenomenon. I use to think it was me or my technique, then maybe the catheter. But, I have found that it can happen to any nurse and any brand of cathter. With PICCs and Midlines. A study would be great but, I could not perform the study due to lack of resources. My lines are placed mainly in the external settings and can not afford to send the resident to IR for a Dye study. But, I believe that this is what is occuring with your catheters as well. I now use the Groshong 4Fr single PICC but, previously used the V-Cath as well and both cathteters can have this happen. I can tell you that when you take the line out nothing will be on the catheter. And after inserting another catheter some patients will continue to develope these sheaths. Some do not. Without a study of the patients labs, medications, and previos history I am afraid an answer is not forthcoming as to what patient will or will not develop these sheaths. I have ask many experts and catheter reps and no one seems to have the answers. Actually most think it is the fault of the inserting nurse and their technique. I believe it is with the patient and their physiology. Just my two cents. Randy -- Randy Ross R.N., B.S.N. IV Nurse Consultant, President & C.E.O. IV's Etc... LLC Vascular Access & Consulting Ph: 317-541-6463 Fax: 317-894-7709 Email: [EMAIL PROTECTED] Website: www.IVsEtc.com -------------- Original message ---------------------- From: "Nancy Sullivan" <[EMAIL PROTECTED]> > Here goes some question about Midline. > My hospital IV team (that I am on) has stopped putting in midlines because we > were experiencing leaking at the insertion site. > Is any one else experiencing this problem. > Also, Do you place them in the ac or upper arm? > Do you use MST and or ultrasound to place a midline? > Where is the tip if you use the upper arm? > We use Bard 4fr groshong ad 5fr dual per q cath midlines, that is if we happen > to put one in. > Thanks > Nancy > > > > --------------------------------- > Brings words and photos together (easily) with > PhotoMail - it's free and works with Yahoo! Mail.
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 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. -----------------------------------------------------
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 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.
----------------------------------------------------- |
BEGIN:VCARD VERSION:2.1 X-GWTYPE:USER FN:Nichols, Heather TEL;WORK:562-3530 ORG:;IV specialist EMAIL;WORK;PREF;NGW:[EMAIL PROTECTED] N:Nichols;Heather TITLE:RN END:VCARD
