The opposite side is preferable if possible. The older pacers
will have less risk of lead fracture. Insertion of PICC has not been
documented to cause a lead fracture. I have found one published case
of catheter removal leading to lead fracture because there was a
thrombus bridging between the CVC and lead, but this was not a PICC.
Lynn
At 1:43 PM -0500 3/1/06, Ward Gina wrote:
What is the general consensus on putting a picc in on a site with a pacer? does it need to stay opposite side. If it has been in a long time is that ok? Definite contraindication?
I am relatively new to this . Thanks Gina
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
Sent: Mon 2/27/2006 1:37 PM
To: Ward Gina; [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: Re: dressing changes and protocol/procedures for DVT in PICC Arm
When we first started our program 12 years ago we did the same thing. All the dressings. What we found was that by the PICC team doing the dressing the nursing staff did not take complete ownership for the line. The PICC became the property of the PICC team. That was a problem when there were issues on the off shifts.
We educated every nurse in the hospital and now capture the new hires during orientation.
We also have what we call expert resource nurses. Theses nurse can tPA, and remove PICC's, . They are the ones the staff is to call first to trouble shoot their lines if they have a problem.
This is working good.
We hold the classes for the resource nurse quarterly.
Linda Lembo
New Jersey
-----Original Message-----
From: Ward Gina <[EMAIL PROTECTED]>
To: Helen lazeration <[EMAIL PROTECTED]>; [EMAIL PROTECTED]
Sent: Mon, 27 Feb 2006 09:22:29 -0500
Subject: RE: dressing changes and protocol/procedures for DVT in PICC Arm
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We the 2 trained PICC nurses (myself and another nurse), who also work fulltime in other areas in the hospital, do all the PICC dressing changes. We know they (floor and ICU nurses ) have done Central line dressing changes in the past, but we also know what they end up looking like and have seen some of them in action.
We just started our PICC program 5 months ago, we wanted to keep it a smooth as process as possible and keep our complications down to a minimum. So, we decided we would do all the drssing changes. We did provide a class for all nursing staff on care of and use of the picc. The nurses are elated and we have had no problems with infections. We also chose to use the Biopatch dressing to make our dressing changes down to every 7 days after the initial 24 hour change.
We initiate a file on each pt and also a log to keep up with the dressing changes, it has worked well so far. Of course we do only about 20-30 piccs a month and our average length of stay for our lines is about 14 days.
We have not had to deal with DVTS yet.
Thanks, Gina
From: [EMAIL PROTECTED] on behalf of Helen lazeration
Sent: Sat 2/25/2006 3:18 PM
To: [EMAIL PROTECTED]
Subject: dressing changes and protocol/procedures for DVT in PICC Arm
Need some help with two items:
Just need an informal survey on how many facilities have their IV/PICC Teams do the routine dressing changes or if the nursing staff do the changes and how everyone feels about the nursing staff on the floors doing the routine dressing changes.
Also, if there are any facilities out there who have physicians leave a PICC in place with a DVT and anti-coagulate the patient to try and break down the DVT? If so, do you have a policy/procedure in place for this scenario that you would be willing to share?
Helen Lazeration, CRNI
Fairbanks Memorial Hospital
Fairbanks, Alaska
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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
