From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Nadine Nakazawa
Sent: Monday, October 23, 2006 3:40 PM
To: [EMAIL PROTECTED]
Subject: Re: reverse tapering
This discussion is interesting, but I'll throw in another issue. At our facility, we rarely insert the entire catheter in. We base our final external length based on the PICC tip being at the caval-atrial junction, and the excess is outside. We stabilize the excess by applying a wing (we use the 7 Fr wing on the 5 Fr PowerPICCs), about 1-1/2 cms from the exit site. I know we are one of the few places that sutures, but we do suture to one side of the wing, and then tie down the wing loops (or whatever you call them) to secure the wing onto the catheter. We then use a StatLock on the bifurcation of the dual lumen PICC.
The reason I like the taper on the PICCs is that is prevents (for the most part) kinking of the catheter right next to the hub. It creates a smoother transition from that hub to the catheter.
From: "Cheryl Kelley" <[EMAIL PROTECTED]>
To: "Michelle Hansen" <[EMAIL PROTECTED]>, "Laura Cook RN" <[EMAIL PROTECTED]>, "Lynn Hadaway" <[EMAIL PROTECTED]>, [EMAIL PROTECTED]
Subject: Re: reverse tapering
Date: Thu, 19 Oct 2006 11:08:11 -0400
>So why are we using the reverse taper? To make thing more convenient
>for the nurse? Less messy for the patient? Biopatch at time of
>insertion? Really I would rather give the patient a line that will
>be successful, without complications, and dealing with a dressing
>change in 24 hours is not a big deal. I will admit thought that in
>patient's on Coumadin, it is nice to "plug" the skin nick, but
>really we have been successful with applying a small pressure
>dressing on these sites.
>
>Cheryl Kelley
>PICC Nurse and Infusion Consultant
> and
>PICC Nurse at West Virginia University Hospitals
>304-823-3196 or 304-669-3061
>
>
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