Here's the newest event which raises some red flags on my part... the
other day, pt with an existing right picc has a site infection, s the
order was to place a new picc on the left. this pt historically has
not had a successful picc on the left(2 midlines.. unable to advance
both times). Knowing this, I took the pt to IR and the venogram shows
no direct communication from the left subclavian to the right. Both
dumps straight into the RA, but the left has an obscure angle
preventing the PICC from advancing. The radiologist used all kinds of
wires, but still couldn't advance through the sharp angle. So he gave
up and left the PICC at the subclavian. He says its fine wher it is. I
told him, i'm not supposed to leave it there, but it was his call. the
pt has TPN going.
I know our literature says not to leave it in the subclavian, but if
the Rad says to leave it there, I had no choice.
I'm thinking to give the right arm a rest a few days and insert a new
one back there again.  What would you do?


--
Roger Soriano, RN
Vascular Access Specialists
818-687-8348

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