Tell your group that I just met with the Chief of IR at Stanford, "Rusty"
Hofmann and he gave me that very article! This is what he wants to do for
all PICC referrals the PICC team sends them. He says that we are only
sending the MOST difficult vasculature pts to them,and if we can't get a
PICC in then they have struggled for hours to get them in and he strongly
feels we aren't doing what is best for patients. Anyway, we are going to
start dong this (IR first, PICC team later) once I get all the education out
there about this "new" line.
I disagree with Lynn. Although it is tunneled, it willl look different as
they will be using a short tunnel with a small bore , 5 or 6 Fr PICC,
without a cuff. It is easier to remove because it's small with no cuff,
easier to insert. A Hohn does not have a tunnel (as I recall) and is
usually inserted percutaneously into the subclavian or IJ. This SBCC or
tunneled jugular SMCC will require some staff nurse and community education
to get nurses comfortable with it's location, higher infection rate due to
skin but less with the tunnel, how to remove it, how to secure it, etc.
Nadine
From: "Nancy Costa" <[EMAIL PROTECTED]>
To: "Nadine Nakazawa" <[EMAIL PROTECTED]>, [EMAIL PROTECTED]
Subject: Re: tunneled small-bore CVCs
Date: Wed, 16 Aug 2006 08:53:56 -0400
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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