Rhonda,
I can get you the references you
need. I cannot look them up until
Thursday, however.
Left-sided approaches, especially those
near the AC, require a longer line.
Also, left-sided approaches generally make more turns. Both of these circumstances increase the
patient’s risk for developing thrombosis.
Michelle Followell
-----Original Message-----
From:
[EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Lynn Hadaway
Sent: Monday, August 14, 2006 1:11
PM
To: Zenger Rhonda; [EMAIL PROTECTED]
Subject: Re: Left arm thrombosis
The speaker you heard in Kansas City should have
provided a list of references. If not, I would not give much credibility to
what they said. Lynn
At 10:14 AM -0500 8/14/06, Zenger Rhonda wrote:
I apologize for not being clear with
my question. What I am trying to find out is there any research based
information regarding an increased incidence of thrombosis and/or complications
when using the left arm for PICC placement. In the past, we would visualize
both arms with ultrasound and then choose the arm with the best vein for
access. However, I attended a workshop in Kansas City and the speaker reported
an increased incidence of thrombosis is associated with using the left arm. He
recommended the using the right arm first unless contraindicated and then using
the left arm. Now, we use the right arm for PICC placements unless there is a
contraindication then we use the left arm. One of our team members continues to
use the left arm no matter what the situation is because the CRNAs have
informed her it is the easiest and best approach. She also uses a close to the
AC approach on the left arm. This makes it very difficult to take care of the
PICC due to its location close to the AC. I am trying to change her practice
approach, if possible. If anyone has any literature or information to support
not using the left arm routinely and not choosing a low AC approach for PICC
placements it would be helpful. We use ultrasound with MST.
Thanks so much,
Rhonda
Zenger, MSN, RN
Advanced
IV Services
Mercy
Regional Health Center
Manhattan,
Kansas
785-323-6835
[EMAIL PROTECTED]
--
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
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