PICC becomes personal

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    In a horrible twist of fate, my 17 year old step-daughter was in a major car accident (recovering now and hopefully all will be well in time) and has a PICC line. I'm an RN on the IV team and insert and care for PICCs all the time. I guess I never realized that there is such an opposition to them in some departments of our hospital. Radiology didn't want to use it (it's a power PICC and OK for use for everything except gadolineum (?sp)), the OR didn't want to use it, and some of the nurses were upset that she's a nurse draw for labs. This poor kid has horrible veins and doesn't need any more pokes....my colleagues had trouble getting a 4 french in. I can't imagine how many times she would have been poked by now if I weren't insisting that they use the PICC. Does anyone else run into this?? I would have laughed if it hadn't been so ridiculous when the pre-op nurses said "well, we don't use PICCs. the meds don't get into the pts system as quickly as an IV!" Practically had to throw myself on top of her to prevent a poke and anesthesia finally agreed that the PICC was adequate access (and if they did have to add another line, wait until she's asleep). OK, done ranting, but is it just at my facility or do you find it elsewhere?
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    What it really is....is a lack of knowledge. When a nurse can not get in a PIV they are begging for a PICC at my place of employment..they love them here..we can barely keep up. A power PICC is an open-ended PICC as you know and has very good flow rates. That is what they are worried about in OR..they think they need a short PIV to get a bolus in and run the IVF at a rapid rate...what they do not realize is that with Ultrasound we are placing them much higher and it is making them shorter. with all the configurations they come in esp the triple lumens..the power injectable lumen is very large. Sometimes medical professionals think that a PICC is NOT a central line..that one makes me giggle sometimes. As far as the power injectable capability..the CT techs and rad RNs should always use the power injectable PICCs..Trialysis..and CVCs as their first choice for power injection.....Both types of contrast ( ionic and non-ionic can cause tissue damage if they extravasate...YES there have been many lawsuits. If this is a hospital where you work..you might consider calling your rep and having some inservice to radiology. Here in Ca only and MD or RN can hook up to a CVC for power injection..the techs can do it to a PIV..but it just takes a sec..BUT you must verify patency and verify tip placement. So yes it is a shame you have to advocate for your daughter when the solution is so obvious. What you are doing is preserving her veins for future use as well and that is so important..that is really one of the trends in venous access is to prevent destroying someones veins and then saying " now let us get a PICC" GOOD FOR YOU I would have done the same


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