----- Original Message -----
Sent: Thursday, October 12, 2006 8:14
AM
Subject: RE: Difficult PICC
Removals
Did you do a
correlation versus volume of patients to see if the % is the same. Such
as did your volume of PICC usage per month increase dramatically?
kathy
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We find that we are having an increase in the number of PICCs that are
difficult to remove and requiring the application of heat and time to
facilitate removal. When in the past we had maybe one or two a year, we have
recently had at least 6 in the past month. We always use Bard's Groshong PICC,
4fr 5 fr. All were optimally placed above the ACF in basilic vein.
The patients are from different services so are medical, surgical,
oncology etc. male/female, with varied duration of insertion from days to
weeks. PICCs have been inserted either by palpation or by ultrasound. All
by MST method.
We have only recently (in the past few months) begun to use ultrasound
for inserts.
We do use latex gloves with powder but rinse the powder off before
handling the PICC, however find that we are using multiple pairs of gloves for
the procedure in order to set up sterile field etc. We do the inserts with one
person, no assistants.
Any suggestions as to why this could be happening?
Thanks in advance
for sharing your ideas with us.
Patrice Wilken
Vascular Access Team Nurse
Winnipeg
