OK........when you are talking about > thrombosis with left sided placement,
is your concern limited to those lines whose tip is in the proximal svc
(causing svc syndrome?) or does left sided placement carry additional risks
of thrombosis in other vessels?
Alma Kooistra RN, CRNI
----Original Message Follows----
From: "Kokotis, Kathy" <[EMAIL PROTECTED]>
To: "Zenger Rhonda" <[EMAIL PROTECTED]>, [EMAIL PROTECTED]
Subject: RE: Left arm thrombosis
Date: Mon, 14 Aug 2006 10:18:17 -0600
left side has a higher rate of thrombosis in the literature
I am forwarding your message to Slyvia Pyc at Bard who is the clinical
resource nurse to see if she can come up with a bibliography of articles
for you on left sided placement of VAD's and thrombosis
kathy
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________________________________
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Zenger Rhonda
Sent: Monday, August 14, 2006 8:15 AM
To: [EMAIL PROTECTED]
Subject: Left arm thrombosis
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]
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