2 catheters residing inside the SVC is done but should be reserved
for those rare times when it is in the patient's best interest to do
it - risk vs benefit assessment. I don't know how you are using the
abbreviation PAC as this could be many things. What were your reasons
for thinking this PICC was unnecessary and why did the physician want
it? As Leigh Ann stated in a previous message, we are the vascular
access consultants and as nurses we must do our own assessment and
not be forced into doing something simply because it was ordered. Lynn
At 8:17 PM -0700 6/5/06, Karen Douvillier RN wrote:
Here is a situation the I encountered today and was not happy with.
A doc ordered a PICC on a patient with a PAC. The patient, of course has
the PAC in the distal one third of the SVC. I was instructed to place a
PICC. I didn't think this was a good idea simply because BOTH lumens would
have resigned in the distal one third of the SVC and I was afraid that the
PICC tip could cause a little bit of a problem with entanglement should this
happen. The reasons for wanting BOTH didn't make sense.
Has anyone ever done this...both lumens in the SVC? If so why? I didn't
want to do this because I felt that this was unnecessary.
Please...give feedback. The radiologist said it is done all of the
time...but it's my license should something go wrong and I wasn't
comfortable.
Karen
San Clemente, CA
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
On Behalf Of Gwen Irwin
Sent: Monday, June 05, 2006 6:06 PM
To: [EMAIL PROTECTED]
Subject: Re: Arterial sticks
Nina,
We don't have a policy for this, but the PICC nurses know when they have
inadvertently accessed an artery and document this and their response. It
has occurred, but their response is immediately to remove the PICC and
therefore, the access site and hold pressure x 5 minutes, then document the
distal pulses after the occurrence.
However, we have also had a few that were not arterial, but had such a brisk
blood return that we reacted to that and REMOVED the PICC. We have learned
from that also.
I do not have references that relate to arterial hematomas, like you asked.
Gwen Irwin
Austin, Texas
----- Original Message -----
From: "Nina Ainslie" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Friday, June 02, 2006 12:23 PM
Subject: Arterial sticks
We are developing a competency to follow for inadvertent arterial
sticks, and arterial cannulation when performing PICC insertions. Does
anyone have references related to arterial hematomas?
Nina Ainslie, RN, BS, CRNI
Infusion Nurse Specialist, PICC Services
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Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
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