so the update is that we are going to try IV abx, will
pull the line if s/s does not improve.


--- Lynn Hadaway <[EMAIL PROTECTED]> wrote:

> There have been some studies to document the fact
> that markers of 
> inflammation are not caused by the catheter
> material, both 
> polyurethane and silicone. So I would not think that
> the catheter 
> material is the problem. However, there could be
> stimulation of mast 
> cells by the physical presence of the catheter, both
> materials. When 
> mast cells degranulate, they release histamine and
> heparin plus other 
> factors are metabolized on the mast cell wall
> through lipid 
> synthesis. These factors are responsible for
> extending the signs and 
> symptoms. I have seen the problem of site redness in
> a circular 
> pattern around the puncture site; it never improves
> or gets worse. 
> The difference between what I am describing and the
> original question 
> is that there has never been any drainage from what
> I have seen. In 
> the original question, there was drainage that
> apparently responded 
> to a Biopatch. So I would think this to be an
> infectious process, and 
> not a simple immune respond to the presence of the
> catheter. Lynn
> 
> At 2:30 PM -0700 5/15/06, Dianne Sim wrote:
> >From: Dianne Sim [mailto:[EMAIL PROTECTED]
> >Sent: Monday, May 15, 2006 2:25 PM
> >To: 'Anna Liang'
> >Subject: RE: picc site redness
> >
> >Just as some folks develop keloid tissue more than
> others, I think that some
> >patient's insertion sites respond to the mechanical
> irritation of the
> >catheter in situ and/or the catheter composition,
> in varying degrees. The
> >trick is to know what is considered normal and what
> is not. In the
> >institutions I had worked at, "normal" errythema
> was thought to be anything
> >smaller than 1cm diameter across the site. Of
> course, if you pick up any
> >other signs or symptoms in your assessment, such as
> swelling, induration,
> >exudate, pain, palpable cord it could change your
> diagnosis. In this case, I
> >would probably have the staff continue observation
> of the site qShift and
> >only respond if the errythema increases past 1cm or
> has other S&S.
> >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 information
> >that is confidential and prohibited from further
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> >you have received this e-mail in error, its review,
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> >distribution is strictly prohibited. If you are not
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> >original message and any attachments.[v1.0]
> >-----Original Message-----
> >From: [EMAIL PROTECTED]
> [mailto:[EMAIL PROTECTED]
> >On Behalf Of Anna Liang
> >Sent: Monday, May 15, 2006 7:00 AM
> >To: [EMAIL PROTECTED]; [EMAIL PROTECTED]
> >Subject: picc site redness
> >
> >would like to know your practice regarding dealing
> >with site redness.
> >
> >one kid has a picc, last week there was some
> drainage
> >on the site, and the site is red -- the biopatch
> was a
> >bit swelled up. in order to assess the site, the
> >dressing was changed every 2-3 days with biopatch.
> >there is no more drainage. but the site is still
> red
> >(0.5cm X 0.5cm).
> >
> >should I consider pulling the picc if the redness
> does
> >not improve?
> >
> >__________________________________________________
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> 
> -- 
> Lynn Hadaway, M.Ed., RNC, CRNI
> Lynn Hadaway Associates, Inc.
> 126 Main Street, PO Box 10
> Milner, GA 30257
> http://www.hadawayassociates.com
> office 770-358-7861
> 
> 


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