According to what I read, the lymphedema was above and below the PICC site:
i.e, "with lymphedema
above and below PICC insertion site"
It looks like she was referring to the PICC arm. Is that what everyone
understands?
Helen
Original Message -----
From: "Christine NAYLOR" <[EMAIL PROTECTED]>
To: "Helen Larson" <[EMAIL PROTECTED]>
Sent: Thursday, May 04, 2006 10:36 AM
Subject: Re: What would you do in this situation?
I would never go in an arm with lymphedema. This person needs something
in the chest an acute cath or if needs longer a tunneled cath.
Chris
Chris Naylor RN, CRNI
[EMAIL PROTECTED]
PICC/PRN Team Managerr
Santa Rosa Memorial Hospital
1165 Montgomery Dr. 1W07
707-522-1591
Santa Rosa, CA 95405
FAX 707-525-5378
Consistency,Responsibility,Harmony, Achiever, Relator
"Helen Larson" <[EMAIL PROTECTED]> 5/4/2006 5:55 AM >>>
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.
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