Re: Adult Cystic Fibrosis patients

[Cheryl]

Our adult CF patients are both "frequent flyers" and then others who may only come in for a "wash-out" once a year.  WE will place PICC's on them until we see that they are indeed the ones who come in frequently.  When we get to PICC  number 7 or so in a 2 year period, then we encourage a port.  We also educate the physician that we are pretty much getting to the end of this patient being a PICC candidate.  Our infectious disease doctors are the ones who manage the CF, but they are admitted on to another service.   So we would talk with the ID doc, and most often we are both on the same page, that yes this patient needs a port now.   When we see these patients frequently, we encourage a port, as it may not be long before they are up for a lung transplant.   On one particular patient, when we got to PICC 7 or 8, we encouraged him to get a port, but he refused.   At PICC number 14, we stopped inserting them or managing them.  He is now a IR patient for all PICC's because we felt that we were not doing him a favor by repeatedly inserting PICC"s when he needs a port.  He is the one who has refused a port.....   He is a noncompliant patient in a major way with all aspects of his disease and treatment plans!   His problem is that now he is too sick for a lung transplant.     Cheryl Kelley West Virginia University Hospitals [EMAIL PROTECTED] 304-823-3196 304-669-3061