Hi all-
First timer poster so hope this works.........
I was training a new PICC'er today,his first time after our class and a few
observed placements. Our third call was to the SICU and on the way I
commented that that unit was my favorite to place PICC's--spacious
room,plenty of extra sterile gloves in the room and the telemetry is right
above the bed.
Patient was POD3 after a CABG X 5 and after having MI symptoms for almost a
month,so both ventricles were plenty stressed.Extubated about 1 hour before
we got there. Patient needed 2 lines,so we gave him a 5FR Groshong on the
left and a 4FR single in the right. Both placements relatively routine. Our
CXR's get developped right outside the unit so I had a chance to see the
film before the Rad and the right PICC was a little too deep. I had the new
guy pull back 5cm right away--when the Rad called,he said it needed to come
back 6cm,so we pulled out another 1cm before we dressed it. I glanced at the
monitors a number of times while we were there--nice NSR and good pressures
all the time.
We dressed the lines,finished up paperwork,updated his wife on the
successful placements and went to the next customer 4 doors down.
We had just started to look at the next patient when the bells went off and
the previous patient coded--nurse there said he coughed a few times,went
into VFib and that was that. We hooked up his ext. pacer right away and got
decent pressures again.
Now,there were no arrhythmias during placement of either PICC. None while
the right one was too deep and none after we were done. The SICU nurse,also
a PICC inserter,didn't think our lines had anything to do with the code and
the CV surgeon didn't either. Just wanted to hear what you all might
think....
Thanks,
David Longseth,RN
L'As de Piques
