Hi,
I have 2 questions.
1. When using MST to place PICCS, is it wrong to do the
initial stick with a 22 g. catheter, thread the wire, THEN place the lidocaine
and do the nick? That is how I have been doing it because previously the
lidocaine caused the vein to constrict and I was unable to get the vein
successfully. The way I have been doing it allows me to have success most of
the time. Does INS standards say that we are to prevent ALL pain? I feel like
the pain from the lidocaine is worse than the stick pain of the 22 g. catheter.
2. Can anyone give me proof that using MST is better for the
patient-I need to be able to justify the added expense to my assistant manager
so she can justify the added expense to the higher-ups. (I know it is better
for the patient and better for me) As I see it, the added expense adds up to
ONE MST kit per procedure-about $30 here. Yet we are able to place many more
PICCS than before using this technique. I hate to go back to the dark ages. And
I don't think we will ever get an ultrasound machine.
Thanks for your help,
Cheryl Fry CRNI
University Health Care
Columbia, MO
