I do have similar concerns about the reverse taper feature. If it
consumes the large majority of the vein diameter, you will be
occluding the blood flow through the vein. This leads to thrombus
distal to the catheter and mechanical irritation in the portion of the
vein where the large portion of the catheter lies. We teach this
concept for short peripheral catheters all the time. It does apply to
any catheter such as a PICC. While it is true that vein diameter at
the PICC insertion site is larger than the veins in the lower forearm,
it appears to me that these large tapers can present a problem. This
is yet another area where we need to use good clinical data for our
clinical decisions, not sales and marketing info, and not anecdotal
information. I am hoping that those of you using these catheters will
do a study and publish on this issue. Lynn
At 11:15 AM -0400 10/19/06, Cheryl Kelley wrote:
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
--
Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
