I have seen such a line. When I first saw the patient I was quite perplexed. It was a dialysis patient with a dialysis catheter in Right subclavian. About an inch away from the insertion site of the dialysis cath, there was a PASV catheter inserted. Being a PICC nurse I know the different PICC catheters, my first thought was: " why did they use a PICC cath as a subclavian.?" Then I looked at the CXR.......the dialysis was placed Subclavian, but the "PICC" apparently was tunneled because the path sent up the neck and then down the jugular!!! I wonder who was the first person to 'invent' using a PICC in the IJ. I have heard MD call it an IJ PICC. Mostly these are nephrologist.
If this is going to become more prevalent, we need a better name for it, in my humble opinion. First of all this is not a "peripheral" site. Secondly, would the dwell time be as long as a true PICC?? I think not because of the insertion site being in the dirtier chest. Isn't this how a HOHN catheter is placed??
One thing for sure......I do admire peoples ingenuity in getting vascular access for those TOUGH ONES!.
--
Susan Schuetrumpf, CRNI
VASPRO
Atlanta, GA
cell-404-606-1194
-------------- Original message --------------
From: "Nadine Nakazawa" <[EMAIL PROTECTED]>
Does anyone have a good name for these "small bore tunneled CVCs" that can be placed into the IJ with a short tunnel, that are 6 or 7 Fr in size? Tim or Ann: What do you call these lines? Especially if they are a PICC that has been trimmed and used in the IJs for patients with no decent vasculature in the arms for a regular PICC??
Our IR Chief feels that if the PICC team refers them a patient where we failed to get the PICC in, they will likely have the same troubles. Bad veins are bad veins. He wants to start putting in these lines when we refer them to IR for a failed PICC insertion. I think it dovetails very well with earlier discussions about all the bad vasculature out there. It's getting to be a real problem.
Our numbers are excellent and we seen to only refer the truly difficult access situations.
Nadine Nakazawa, RN, BS, OCN
PICC Program Coordinator
Stanford University Hospital and Clinics
Stanford University Medical Center
