Interesting to think about the reduced bleeding creating a larger insertion site clot from the tamponade of the site and the possibility that it may propagate into larger clot over time thus resulting in more thrombosis?? Care to set up a study, Cheryl, comparing non tapered with reverse tapered catheters? I am sure a few companies would assist with some product. A number of the companies now provide both choices, Angiodynamics, Medcomp, Arrow to name a few.
Nancy Moureau, BSN, CRNI PICC Excellence, Inc. 888-714-1951 www.piccexcellence.com [EMAIL PROTECTED] -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Cheryl Kelley Sent: Wednesday, October 18, 2006 10:23 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
