In what way did the patient move after insertion? Sit up, stand up,
walk around, or just move his arm while in bed. PICCs are known to
move, so arm movement could have caused the catheter tip to move into
the heart. Or indeed it could have simply been coincidental that this
event occurred immediately following the PICC insertion. Were there
any other signs or symptoms before the Vfib? Lynn
At 6:49 PM -0500 5/17/06, DAVID LONGSETH wrote:
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
--
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
