Shocking cases re: access

[DAVID LONGSETH]

Monday,first PICC order of the day. Patient came in severely hypotensive,had 
a PIV in place from EMS,another placed in ER. Gave her some FFP,fluids, 
Dopamine. Sent her to the unit,PICC placed. Intensivist came in just as I 
was in the middle of the insertion and watched while I did it-routine 
procedure. The doc was surprised it looked so easy. Why?  He said the lady 
had been stuck 7 or 8 times in both groins and the chest in the ER because 
they wanted a central line--no success. Her INR was 9-point something at the 
time. Repeatedly doing blind sticks on the lady? Shocking.

Second case. PICC patient yesterday,a RN that used to work at a small area 
hospital. Said that if a patient comes in there with a PICC,there is a 
doctor or two that will order it D/C'd and place his own central line,saying 
the risks of infection,embolization and whatever are too high with PICC's. 
Puh-lease--of course he gets paid a little money to put in his own 
line,doesn't he? Sounds fishy to me,but then I am a little biased.
Have a nice day
D