From: "Nancy Moureau" <[EMAIL PROTECTED]>
To: "'Nadine Nakazawa'"
<[EMAIL PROTECTED]>,<[EMAIL PROTECTED]>,<[EMAIL PROTECTED]>
Subject: RE: tunneled small-bore CVCs
Date: Thu, 17 Aug 2006 08:01:00 -0400
Could use a Vitacuff in the tunnel or just a biopatch to reduce the
infection risk.
Nancy Moureau
-----Original Message-----
From: "Nadine Nakazawa" <[EMAIL PROTECTED]>
To: "[EMAIL PROTECTED]" <[EMAIL PROTECTED]>;
"[EMAIL PROTECTED]" <[EMAIL PROTECTED]>
Sent: 8/16/06 5:23 PM
Subject: Re: tunneled small-bore CVCs
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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