We also need some portion of the catheter sticking out of the skin in order
to properly place Biopatch around the catheter at the exit site. that
means a minimum of 1-1/2 cms.
Nadine Nakazawa
From: yh groups <[EMAIL PROTECTED]>
To: Nadine Nakazawa <[EMAIL PROTECTED]>, [EMAIL PROTECTED]
Subject: Re: reverse tapering
Date: Thu, 26 Oct 2006 14:28:30 -0700 (PDT)
I agree with this. Is there anyone out there putting these reverse taper
piccs in up to the hub? If so, then I might have some concern. I don't
believe the hubs were intended to be blunt with the skin. If your placing
them properly it pretty much makes this a non-issue correct???
Nadine Nakazawa <[EMAIL PROTECTED]> wrote: 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.
Nadine Nakazawa, RN, BS, OCN, CRNI
PICC Program Coordinator
Stanford University Hospital and Clinics
Stanford University Medical Center
---------------------------------
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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