This really sounds like a great study if anyone is willing to take it on. We've had a few incidences of Vtach which resolves as soon as the PICC is pulled back into the SVC. This is a very small number, but can cause seroius problems, create many more unncessary costs/tests/risks for the patient if the nurse doesn't put together that the PICC slipping into the atrium could cause ectopy. We're currently exploring how we can get a better handle on this.
Glad to hear we are not alone. This list serve is great to hear others experiences and thoughts. Pat Deisch MSN, RN BryanLGH Medical Center ----- Original Message ----- From: "Dianne Sim" <[EMAIL PROTECTED]> Date: Wednesday, May 10, 2006 8:56 pm Subject: RE: telemetry and PICCs > Admittedly, the risk is here, but how big a risk is it, and at > what point > can you justify the extra cost of telemetry/monitoring? Our team > has placed > 5,567 PICCs at the bedside since 1/1/2000, with approx. 80% without > monitoring, and not had a single problem with ventricular arrythmias > perceived. > Regards, > > > Dianne Sim RN > CEO & President > > > > > > > > IV Assist, Inc., > > 2675 Appian Way > > Pinole, CA 94564 > > Phone: (510) 222-8403 > > Fax: (510) 222-8277 > > Email: [EMAIL PROTECTED] > > > > > > > > Confidentiality Notice: This e-mail and any attachments are > intended only > for the use of those to whom it is addressed and may contain > informationthat is confidential and prohibited from further > disclosure under law. If > you have received this e-mail in error, its review, use, retention > and/ordistribution is strictly prohibited. If you are not the > intended recipient, > please contact the sender by reply e-mail and destroy all copies > of the > original message and any attachments.[v1.0] > > _____ > > From: [EMAIL PROTECTED] [mailto:owner- > [EMAIL PROTECTED] Behalf Of Heather Nichols > Sent: Tuesday, May 09, 2006 11:54 AM > To: [EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED] > Subject: Re: telemetry and PICCs > > > > I have not seen much documented on this either, but anyone who > does PICC > placements knows it happens frequently. It is not exactly a study > thatsomeone would come in and volunteer for. > > I have often wished I could carry around a portable monitor > to place on > anyone I put a PICC in. It may seem like over kill, but I feel > like you can > never be too cautious. I myself have put a patient into v-tach > while placing > a PICC. It was barely in the right atrium. I would never have > known if the > patient had not had a monitor. He was sedated and therefore > unable to > verbalize. The cost would not be that much if you were smart > about it. Get > your own portable monitor, or have one in the room you are using > to place > lines. Any nurse placing PICC's for a living should be able to > recognizeectopy, so you really do not need anyone else to monitor. > > > > > Heather Nichols RN BSN CRNI > Infusion Services > University of Louisville Trauma Institute > 530 S. Jackson St. > Lou. Ky. 40202 > (502)562-3530 > > >>> "Kilbourne, Susan" <[EMAIL PROTECTED]> 5/9/2006 1:23 PM >>> > > 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 > telemetryduring 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 > > > > NOTE: The information contained in this message may be privileged and > confidential and protected from disclosure. If the reader of this > message is > not the intended recipient, or an employee or agent responsible for > delivering this message to the intended recipient, you are hereby > notifiedthat any dissemination, distribution or copying of this > communication is > strictly prohibited. If you have received this communication in error, > please notify us immediately by replying to the message and > deleting it from > your computer. > > E-mail has the potential to have been altered or corrupted due to > transmission or conversion. It may not be appropriate to rely upon > thisE-mail in the same manner as hardcopy materials bearing the > author'soriginal signature or seal. Thank you. AsanteR Health System > > > ----------------------------------------------------- > Confidentiality Disclaimer > > This message, including any attachments, is confidential, intended > only for > the named recipient(s) and may contain information that is > privileged or > exempt from disclosure under applicable law, including PHI > (Protected Health > Information) covered under the Health Insurance Portability and > Accountability Act (HIPAA) of 1996. If you receive this message > in error, > or are not the named recipient(s), please notify the sender or > contact the > University of Louisville Health Care I.S. helpdesk at 502.562.3637 > to report > an inadvertently received message. > >
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