RE: reverse tapering

[Earhart, Ann]

So what evidence is everyone using to decide if the vein is “large enough” to support a 5 or 6 french catheter, or a tapered catheter? What parameters are everyone following, or have you developed to determine “appropriate vein size”? Yes, we have our parameters, but wanted to provoke some thought and interesting conversation to see how everyone has determined their practice/guidelines and if you have written them into your policies/guidelines.   Ann Earhart, MSN, CRNI Clinical Nurse Specialist-Adult Vascular Access/PICC Team Banner Desert Medical Center Mesa, Arizona  85213 office-480-512-3980 pager-602-420-3240 e-mail:  [EMAIL PROTECTED]   From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Cheryl Kelley Sent: Thursday, October 19, 2006 8:16 AM To: [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: Re: reverse tapering   All veins should be assessed in depth when placing large lumen lines, such as the 6F triple or the tapered lines.  We measure the vessel and then decide if it is large enough to accommodate the catheter.  There are some patient's who simply do not qualify for a triple simply because the vein is not large enough.  Of those who qualify, the measurement that we take is to see if the vein can accommodate the 6F catheter.  I guess we should also be looking at how large the vein is at the insertion site, where the catheter is tapered to an 8 or 9F.  Isn't the whole concept of decreasing thrombus allowing blood to continue to flow inside the vessel?   Cheryl Kelley RN PICC Nurse and Infusion Consultant                     and PICC Nurse at West Virginia University Hospitals 304-823-3196    or     304-669-3061