More accurate than what? A CVC catheter? A PICC?
In many patients the sheath introducer does not reach the SVC. Is he/she talking about monitoring through the side port? I hope they are not talking about leaving the sheath in without a catheter in it, and using it as though it is a central line. We consider this to be a high risk device, and do not consider it to be a central catheter, since it often does not make it to the SVC (depending upon size of patient). The risk of air embolus exists if the line is dislodged, or if the system is opened. Our policy is to remove this device and insert a regular peripheral, or to replace it with a PICC or percutaneous CVC if central access is needed. We consider these to be peripheral devices, so avoid leaving them in after a Swan-Ganz is removed. Our limit for leaving a peripheral device in place is 96 hours. These are stiff, and may increase the risk of mechanical phlebitis, as well as chemical
phlebitis if anything irritating is infused.
What do the manufacturer's directions for use say? Is it labeled for this use? If not, refuse. It is not the MD taking responsibility for misusing the device. If the doctor insists that this is appropriate, demand to see the published evidence.
Leigh Ann
-----Original Message-----
From: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED]; [EMAIL PROTECTED]
Sent: Mon, 9 Oct 2006 3:57 PM
Subject: question
Does anyone have the answer about using a subclavian cordis introducer for monitoring CVP's? Is the lumen size what determises the validity or the length and position/ Our trauma attending feels it is more accurate. Thanks ----------------------------------------- CONFIDENTIALITY NOTICE: This email and any attachments may contain confidential information that is protected by law and is for the sole use of the individuals or entities to which it is addressed. If you are not the intended recipient, please notify the sender by replying to this email and destroying all copies of the communication and attachments. Further use, disclosure, copying, distribution of, or reliance upon the contents of this email and attachments is strictly prohibited. To contact Albany Medical Center, or for a copy of our privacy practices, please visit us on the Internet at www.amc.edu.
