Re: PICCs and Creatinine levels

[Nancy Costa]

Congratulations, Robin, on your CRNI!   I think a must read on this subject for anyone placing PICCs is:   "Venous access for patients with chronic renal failure or end-stage renal disease - What is the role for peripherally inserted central catheters?"  T Saad MD and T Vesely MD.  JAVA.  2003:8(4):27-32.   IMHO - I would not place a line in this particular patient without more information regarding her vascular status, but, failed dialysis access in a limb may render it unsuitable for future attempts.  In such a case, it is usually acceptable to place a VAD above the graft.  I would consult the nephrologist re: vascular access history as well as future needs and document accordingly in the patient record.   EJ "PICCs" are considered suitable access for most renal patients.  A good resource:   "Use of the External Jugular Site for PICC Insertion"  G Danek RN and T Mayer RN.  JVAD.  2001;6(1):14-17.   Hope this helps, please let us know how you fare... Nancy Costa CRNI   ----- Original Message ----- From: Bell, Roberta M. To: Venous Forum (E-mail) Sent: Friday, September 22, 2006 8:51 PM Subject: FW: PICCs and Creatinine levels   -----Original Message----- From: Roger Soriano [mailto:[EMAIL PROTECTED] Sent: Friday, September 22, 2006 9:32 AM To: Bell, Roberta M. Subject: Re: PICCs and Creatinine levels I got an order from a MD yesterday for a PICC to a patient with a creatinine of 4.4.  The nephrologist came and left because the lady is 300lbs so cleared the PICC to be inserted.  The patient has 2 old shunts on both forearms, now has an ashcath on the left subclavian.  Is this going to be ok? On 9/21/06, Bell, Roberta M. <[EMAIL PROTECTED]> wrote: The logic would be because the patient could be renal and usually needs clearance from a nephrologist prior to placing a PICC. Robin Bell RN, BSN, CRNI (today)         -----Original Message-----         From: [EMAIL PROTECTED] on behalf of Czapracki, Denise         Sent: Thu 9/21/06 11:05 AM         To: venous         Cc:         Subject: PICCs and Creatinine levels         Does anyone have knowledge of this relationship as a deterrent to placing PICCs???? -- Roger Soriano, RN Vascular Access Specialists 818-687-8348 CONFIDENTIALITY NOTICE: This e-mail message, including all attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. If you are not the intended recipient, you may NOT use, disclose, copy or disseminate this information. Please contact the sender by reply e-mail immediately and destroy all copies of the original message including all attachments. Your cooperation is greatly appreciated. Internal Virus Database is out-of-date. Checked by AVG Free Edition. Version: 7.1.385 / Virus Database: 268.12.4/448 - Release Date: 9/14/2006