The contraindication for using the same side on a new site is the risk that the
PICC and Pacer leads can heal together in that subclavian track, especially at
the site of the lead insertion into the subclavian vein. In a well established
pacemaker, you run the risk that the vein is already filled with pacer leads or
that it has suffered sclerosis. I have actually witnessed a pacemaker placed in
the same side as the PICC (PICC first) and the pacer leads were sutured to the
PICC and it (the PICC) then had to be surgically removed.
-----Original Message-----
From: [EMAIL PROTECTED] on behalf of Ward Gina
Sent: Wed 3/1/2006 10:43 AM
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED]
Cc:
Subject: RE: insertion of picc in pacer site
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
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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