Toshi,
I will answer in caps below. Hope this helps.
Gwen Irwin
Austin, Texas
Manager of Children's Hospital of Austin PICC/IV Team
----- Original Message -----
From: "Toshi Holland" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Friday, April 14, 2006 6:18 PM
Subject: sedation
We are small (about 200 beds) pediatric hospital. We used to do conscious
sedation on the ward but becuase of JCAHO regulations and staffing needs,
all PICCs requiring sedation are done in OR under general anesthesia
except ICU and NICU. Currently we are entertaining an idea of creating a
procedure room where we can do PICCs. I have a few questions for the
group:
Do you have a procedure room for PICC placement? WE HAVE HAD A PICC ROOM
FOR 1 YEAR AND 2 MONTHS. IT HAS BEEN A GREAT IMPROVEMENT IN THE PICC
PROGRAM.
If so, who orders and administers conscious sedation? 95 % OF ALL OF OUR
PATIENTS ARE AWAKE WITHOUT CONSCIOUS SEDATION. THANK GOD FOR CHILD LIFE
SPECIALISTS AND TOPICAL LOCAL ANESTHESIA. OF COURSE, THE PICC/IV TEAM IS
VERY GOOD AT IDENTIFYING THE PATIENTS THAT MIGHT BENEFIT FROM SEDATION OR
GENERAL ANESTHESIA (MOST IN THE AGE RANGE FROM 12-26 MONTHS). WE ARE
CURRENTLY REVIEWING THE CONSCIOUS SEDATION POLICY AND THE MEDICATIONS USED
FOR PEDIATRIC PATIENTS. THERE ARE SOME MEDICATIONS BEING IDENTIFIED IN
THIS GROUP THAT WILL IMPACT CHANGES, BUT RARELY ARE OUR PATIENTS
PRE-MEDICATED. ANESTHESIA DOESN'T SUPPORT CONSCIOUS SEDATION. THEIR VIEW
IS IF A PATIENT NEEDS THAT TYPE OF SEDATION, THEY PROBABLY REALLY NEED
GENERAL ANESTHESIA (AND THOSE PATIENTS HAVE PICCs INSERTED IN THE OR).
Do you have nursing support for conscious sedation including recovery
period? N/A
What service can you bill to patient? PICC EQUIPMENT (HOWEVER, FINANCE IN
THEIRWISDOM, ESCALATED THAT TO INCLUDE NURSING TIME)
How many PICCs do you perform per month? AVERAGE 30 (110 BED HOSPITAL)
Thank you,
Toshi Holland
Vascular Access Coordinator
Children's Hospital Oakland, CA
