RE: Question for the group.

[Margy Galloway]

Susan,

This is always a dilemma.  We usually see the new ICD placed  after 48 of antibiotics.  So we would attempt on the left side only after

discussing with the physician any difficulty of ICD removal.  We would also remind him the patient has a chance to be at higher risk

for thrombus in this area due to the manipulation.  We also discuss the possibility of sending the patient to IR for left jugular placement.

Our cardiologist always want us to avoid the new insertion side. 

I don't know of any documentation to guide you with this decision. 

Margy Galloway, RN

---

From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Susan Fullana
Sent: Saturday, April 15, 2006 5:15 AM
To: [EMAIL PROTECTED]
Subject: Question for the group.

Senario: Pt with removal of infected ICD generator left side. Vanco x6 weeks. ICD to be replaced on the right side-Not clear when (could be prior to discharge, but pt states in 5 weeks). Pt will require PICC-which side would you place PICC. We seem to have conflicting opinions in our dept. Thanks.

Susan J. Fullana