Helen,
I think that I read that the PICC line is in the Left arm and the Right is the
mastectomy side. It looks like she is trying to say that the edema in the PICC
arm (left) is greater than the arm with lymphedema (right).
Robin
-----Original Message-----
From: [EMAIL PROTECTED] on behalf of Helen Larson
Sent: Thu 5/4/06 4:00 PM
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]
Cc:
Subject: Re: What would you do in this situation?
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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