[vascular] RE:Unable to get PICC into SVC

[Leigh Ann Bowe-geddes]

I never, never leave a tip midclavicular. I also do not rely upon physicians to know the appropriate tip termination for any medication. It is my responsibility to make sure that the patient is protected from inappropriate tip terminations. I agree with your supervisor. If you cannot get to SVC, pull back to midline (or insert PIV, so there is no question of tip termination), and schedule for I.R. It is good to have the documentation to show the dangers of leaving a line midclavicular, and explain it to any interested physician. The NAVAN tip termination position paper is helpful for this. 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] 3/5/2006 2:39 PM >>> I had a patient last week in ICU who had a PICC line ordered, but PICC kept going into the IJ after 3 attempts to get it to go SVC.  I ended up pulling the PICC back to a Midclavicular tip placement.  This hospital does not have IR and the infusates were irritating in nature. I have come across this situation in the past and have been directed by MD’s to leave the line Midclavicular.  My supervisor says to always pull back to midline and schedule patient for IR.  I would like to know the opinion of those who are more experienced than I.  Thank you in advance, Patty Flack RN If you want to share pictures, use the calendar, or start a questionnaire visit http://www.smartgroups.com/groups/vascular To leave the group, email: [EMAIL PROTECTED] Report abuse ----------------------------------------------------- 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 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. -----------------------------------------------------