If I was a betting woman (and I'm not owning up to anything), I would say that the myocardial damage has a much higher probability of causing his problems. 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 disclosure under law. If you have received this e-mail in error, its review, use, retention and/or distribution 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] -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of DAVID LONGSETH Sent: Wednesday, May 17, 2006 4:49 PM To: [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: re: Telemetry and PICC's 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
