The arm port placed in the basilic vessel is a 7/8.5 French
Have you never seen an arm port?
They stay in a lot longer than a PICC line

Is your thrombosis rate over 6%?  I doubt it!
I do not agree with you.

Show me your rate is over 6%!  Where is your data in a prospective
randomized double blinded study with identical patient parameters in
each group of PICC sizes?

Show me the data

I am tired of this speculation!
Kathy 


 
 
 
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-----Original Message-----

From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Cheryl Kelley
Sent: Wednesday, October 18, 2006 8:23 PM
To: Laura Cook RN; [EMAIL PROTECTED]; Lynn Hadaway
Subject: Re: reverse tapering

There may not be any clinical evidence published yet, but from a
facility that places 5F and 6F tapered lines, I will tell you that yes,
we have seen an increase in thrombus in these patients.  I am wondering
if decreased bleeding at the insertion site is worth the risk that the
reverse taper has. 
It only makes sense to question this as with a 6F catheter that tapers
to an
8 or 9F, being placed in the arm, wouldn't that decrease most if not all
of the blood flow in the vein at the entry site?  This is the area where
the endothelium is already sensitive due to the insertion process, also
consider the even larger gauge of the introducer in the vessel, for 5-10
cm and to me it is a perfect setup for complications.  Just thinking out
loud!  What do you all think?

Cheryl Kelley RN
PICC Nurse and Infusion Consultant
                    and
PICC Nurse at West Virginia University Hospitals
304-823-3196    or     304-669-3061


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