Was there some serious negative outcome that lead
to this decision? There are articles documenting
the fact that cardiac arrhythmia may occur
briefly when the wire or catheter passes the SA
node and enters the right atrium, However, these
same articles do not report negative outcomes
such as cardiac arrest or even any arrhythmia
that lead to treatment. Without fluoroscopy
during catheter insertion, one can not determine
if the catheter has passed into the RA. I would
also point out that inside the RA is the
preferred tip location for some radiologists and
they have not reported any cardiac complications
that have required immediate management. So I
also agree that this is overkill and would want
to know the information behind this decision or
why they have made this decision. Without that
information it is impossible to know what is
motivating this. Lynn
At 10:23 AM -0700 5/9/06, Kilbourne, Susan wrote:
I just had a visit from our infection control
MD. She states that the physicians/surgeons
group have decided that they need to do
telemetry when placing central lines and want to
require it for PICC placements as well. I have
one article from Pediatric Anesthesia that talks
about V-tach with PEDS PICC placements but other
than that, this is not something I have heard of
doing on everyone. I told her my concerns with
added cost, competency and having portable
telemetry units available. Are any of you doing
telemetry during PICC placements? I think this
is overkill but I need all the info I can get
before they act on this.
Sue Kilbourne CRNI, OCN
Clincail Manager Vascular Access/Infusion Services
Asante Hospital Systems
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Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
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office 770-358-7861
