This is used for short term therapy. I know the pH is low for use
of a peripheral site, but unless there is another compelling reason
for a central line, you can manage with a small catheter in a large
vein if you have to. The literature states to change sites every 12
hours but does provide a reason for this recommendation. I think this
means to change to a completely new vein every 12 hours. I would want
much more information from the manufacturer about the reason for this
recommendation. This may be enough reason to justify a PICC but in the
face of a hypertensive crisis, you may not have time to place a PICC
before the drug is needed. This is a situation where you may have to
make a different decision for each patient at the time. Lynn
At 9:42 AM -0600 2/9/06, Erickson, Marcia Charge Nurse
wrote:
In the last two weeks critical care has had two patients with nicardipine gtts. Nicardipine is a Ca channel blocker and a potent vasodilator. It was used in an acute hypertensive episode. It has a pH of 3 and the manufacture's instructions where to change the site q 12 hours. The physicians would not agree to a central line of any kind because they said they were only going to use nicardipine for 2 - 3 days. They wanted us just rotate back and forth between two sites. The physicians need and will receive education in the appropriate use of PICC's, I just haven't finished my presentation yet. There was a disagreement with the nursing staff as to whether rotating back and forth was acceptable or that the sites should be completely changed. Pharmacy did not have an opinion either way. What are your thoughts?
Marcia Erickson RN CCRN FCCM
Charge Nurse IV Therapy
Stormont-Vail Healthcare
Topeka, Kansas
[EMAIL PROTECTED]
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Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
