Other lines could also be used in these situations...it's easy to tunnel
something that's not intended to be tunneled.  Most often, we use Hohn
catheters for this purpose.  But we also tunnel PICCs when needed...in
cases where a pt is mentally incompacitated, young kids, etc.  Gives you
more stability.  We also occasionally tunnel from the IJ out the pt's
back..it's an "out of sight, out of mind" thing that sounds so simple
and yet really works.

Gail

>>> "Nancy Costa" <[EMAIL PROTECTED]> 08/16 8:53 AM >>>
Hi Nadine,
Our radiology group calls them SBCC - small bore central catheter.  In
fact they have published this in Radiology. These are mostly used for
renal patients. 
"Tunneled Jugular Small-Bore Central Catheters as an Alternative to
Peripherally Inserted Central Catheters for Intermediate-term Venous
Access in Patients with Hemodialysis and Chronic Renal Insufficiency" 
Sassadeusz, Trerotola, Shah, Namyslowski, Johnson, Moresco, and Patel  
Radiology 1999; 213:303-306
Nancy Costa CRNI
  ----- Original Message ----- 
  From: Nadine Nakazawa 
  To: [EMAIL PROTECTED] 
  Sent: Tuesday, August 15, 2006 10:29 PM
  Subject: RE: tunneled small-bore CVCs


  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 


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