Re: question about CT

[ccavrn]

This PICC will not be for "NO REASON",  it is to provide IV access for contrast.  PICCs can safely be left in place for years if properly maintained.  Of course, we need to use our advanced knowledge and assessment skills to do what is best for the patient.  My first question would be-what are the alternatives?  MRI? PIV in the EJ?  PIV placed with U/S? No scan at all?  Then, what are the patients other needs--blood draws? IV antibiotics, chemo or other IV medications? Repeated CT scans? What is the diagnosis that is requiring the CT scan? What might that dx lead to?   Keep in mind also that the patients illness does not end with his discharge from the hospital.  Will he need IV access at home or in a long term care facility? If so, they will have the same problem, therefore the PICC line will be needed.   Who will be caring for the line if the patient needs it--home IV nurse, LTC nurse or the pt himself?  Each situation is different, and will have different answers depending on the patient and circumstances.  I do not think we should ever say yes or no without looking at the patient, circumstances and considering what is best for today, tomorrow and the future for this patients diagnosis.

Chris Cavanaugh, CRNI

----- Original Message -----
From: [EMAIL PROTECTED]
Date: Wednesday, August 9, 2006 11:23 pm
Subject: Re: question about CT
To: [EMAIL PROTECTED], [EMAIL PROTECTED]

> I disagree with Chris. No line should be left in place for no
> reason. Standards dictate that a vascular access device be removed
> as soon as it is not clinically necessary. Also, inserting a PICC
> for a one time CT seems extreme to me. We discourage injudicious
> use of PICCs, as the risk of venous stenosis increases with each
> line insertion. We need to preserve these vessels.
> Leigh Ann
>
>
> -----Original Message-----
> From: [EMAIL PROTECTED]
> To: [EMAIL PROTECTED]
> Sent: Wed, 9 Aug 2006 7:23 PM
> Subject: Re: question about CT
>
>
> I would agree that a Power PICC would be a better choice than---
> what is the other choice?
> I would recommend keeping the PICC line though, not pulling it
> after the CT scan.
>
> Chris Cavanaugh, CRNI
>
> ----- Original Message -----
> From: Gail Sansivero <[EMAIL PROTECTED]>
> Date: Wednesday, August 9, 2006 5:11 pm
> Subject: Re: question about CT
> To: [EMAIL PROTECTED], [EMAIL PROTECTED], [EMAIL PROTECTED]
>
> > Yes, we have done this. I'd wonder though if this is the perfect
> > pt for a power injectable port...now on the market! (It probably
> > won't be this pt's last CT, right?)
> >
> >
> > Gail Egan Sansivero, MS, ANP
> > Nurse Practitioner
> > Department of Radiology
> > Albany Medical Center
> > Albany, New York 12208
> > 518-262-5149
> >
> > >>> "Denise Harper" <[EMAIL PROTECTED]> 08/09/06 4:05 PM >>>
> > If you have a patient who needs a CT (that HAS to be power
> > injected) and you absolutely cannot get a peripheral IV (even
> with
> > ultrasound) do you place a power PICC for a 1 time procedure?
> >
> > This question has come up twice today.
> >
> > Thanks,
> > Denise
> >
> >
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