Re: What would you do in this situation?

[Helen Larson]

At our facility several years ago, our Infectious Disease physician ordered a PICC in a lady with a bilateral mastectomy.  The primary physician agreed.  She successfully completed 6 weeks of IV antibiotics.  Then about 2-3 months later we had to insert another PICC for a course of IV antibiotics on the same patient.  Also. successful.  If that is all you can do, then check with the attending physician. It sounds like the other option is to do a chest Groshong. Helen Larson CRNI    ----- Original Message ----- From: [EMAIL PROTECTED] To: [EMAIL PROTECTED] ; [EMAIL PROTECTED] Sent: Wednesday, May 03, 2006 10:44 PM Subject: What would you do in this situation? Hi all Please let me know what you would have done in this situation:   Patient 80+ years, PICC inserted to L. Basilic 4 days ago Cannot use R arm due to mastectomy in the 1960's; needs PICC for cardiac meds, antibiotics, and poor venous access.   Presents with clotted catheter, quarter sized area of redness, tenderness, heat at insertion site + red, warm inner aspect of elbow. In addition, arm below insertion site is diffusely red and edematous (arm circumference measurements on PICC side > than other arm with lymphedema above and below PICC insertion site). Petechiae on ventral side of all 4 fingers, not there yesterday No phlebitis up the vein, no symptoms above the catheter insertion site   Radiologist didn't want to do a venogram, even if the line was declotted first (Don't know if that is because the Dept. had no capability to do it ???? or if they just wanted to go home).   Thanks Nina E.