We frequently have two CVCs sharing space--TLC and PICC--PORT and PICC--Two PICCs (one in each arm)
--
Robbin K. George RN
Vascular Access Resource
Alexandria Hospital Virginia
Robbin K. George RN
Vascular Access Resource
Alexandria Hospital Virginia
-------------- Original message --------------
From: "Cindy Schrum" <[EMAIL PROTECTED]>
> Port a cath was my first (and only) thought about what you meant.
> Sorry, my thoughts dwell on what I'm most familiar with. As Lynn
> says, careful assessment, risk vs benefit etc. Those are assessments
> you would make for each catheter insertion. But the question was
> about both lumens dwelling in the distal SVC. I've never read about
> entanglement, but anything's possible. We had a picc that somehow
> tied itself in a knot. Who knows how that happened!
>
> It doesn't happen frequently that a patient would need more than one
> type of central access, if it did I would question the criteria for
> evaluation. The course of an illness isn't always completely
> predictable.
>
> On 6/6/06, Ly nn Hadaway <[EMAIL PROTECTED]>wrote:
> > 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 th e 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: owner-venous @mailsrv1.ohsu.edu [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 rela te 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
> > >>
> > >> This message may contain confidential information protected by law
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> > >> [EMAIL PROTECTED] or (269) 966-8017.
> >
> >
> > --
> > 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
> >
> >
>
