My understanding is he was advocating that PIV's should be placed under
Ultrasound. Did you understand something different?

-----Original Message-----
From: Tim Talbert [mailto:[EMAIL PROTECTED] 
Sent: Thursday, May 18, 2006 4:04 PM
To: Katie Howard; [EMAIL PROTECTED]; Sally Walker
Cc: [EMAIL PROTECTED]
Subject: RE: Ultrasound for periphs

What blanket statement did he make?  

As an aside, I would place "evidence based-practice" far ahead of
policy or "standard" as a criterion.

Tim

>>> "Katie Howard" <[EMAIL PROTECTED]> 5/18/06 >>>
We had an interesting conversation after his presentation. I have
never
seen so many hostile nurses in my life. He said many controversial
things that were not supported by policy, standard or even
evidence-based practice. The INS standard for PIV dwell time is 72
hours
unless there is a compelling reason to leave the line in longer. I
think
longevity of the PIV is more dependant upon location and infusate than
US use. Also, an important thing to consider is, how are you able to
hold traction on that vein during cannulation? The literature shows
the
importance of vein traction during insertion on phlebitis and thrombus
formation. Did anyone hear Lynn Hadaway's presentation on causes of
catheter complications? She had some very good points. I agree that
ultrasound can be a viable option for IV placement but to make a
blanket
statement concerning the use of ultrasound such as he did is not
supported in the literature nor does it make sense. 

Katie Howard RN CRNI
Intermountain Infusion Pharmacy
IV Therapy Education

-----Original Message-----
From: [EMAIL PROTECTED] 
[mailto:[EMAIL PROTECTED] On Behalf Of Sally Walker
Sent: Thursday, May 18, 2006 9:12 AM
To: [EMAIL PROTECTED] 
Cc: [EMAIL PROTECTED] 
Subject: re: Ultrasound for periphs

Maureen Lawler (and others) have inquired and/or commented about  
using ultrasound for peripheral vascular access. At the recent INS  
conference, Richard Wade did quite an impressive presentation titled, 

"Technologic Advances for Vascular Access Device Placement". Richard  
is the PICC Clinician/Educator at PICC Advantage, LLC, in Queen  
Creek, Arizona (I have no email contact information for him). He  
focused his presentation on the use of ultrasound for peripheral  
lines (of course they use US/MST for PICC's, as well), including  
placement of lines in children. One of the notable outcomes they have 

seen is the increased longevity of peripheral lines using US--most of 

their lines last for 96 hours. Richard included a number of videos of 

the actual ultrasound placement, so was able to demonstrate the  
vessel assessment, catheter placement, etc.

If anyone is interested in pursuing this practice, Richard certainly  
has the experience and seems willing to share what they have learned.

Sally Walker






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