sherlock - page 4

has anyone used the new sherlock picc locating device. we just got it at our hospital..having a love / hate relationship with it..just looking for any suggestions on it!!... Read More

  1. Visit  achoosa1 profile page
    0
    I use navigator too. but I'm not a big fan of it because I don't like to exchange & reinsert the stylet in the PICC catheter. Moreover, there is more risk of getting contamination from putting the corpak stylet in the Navigator unit which requires a sleeve to cover the whole unit.
    Pacermaker patients are contraindicated for using Navigator, Per the Navi manual guide opposed to Sherlock. Sherlocks could be used with the pts with pacers.
  2. Visit  iluvivt profile page
    0
    I have used both and prefer the Sherlock 2 as well...it has save us countless hours of nursing time and we can easily re-position at the bedside. The set-up time is quick as well as clean up. Yes you still need a CXR but that is no a reason to dismiss its use IMO. Again it is the ability to re-position and assess its advancement in real time...PRICELESS!!!!... I always have a good idea when it is going into the Azygos...so when you see it advancing into the upper to mid SVC and then all of a sudden the image seems to drop or srart swing around..suspect Azygos tip placement....YES..... we do not catch them all..but then we can go power flush them into position
  3. Visit  picclineman profile page
    0
    Quote from achoosa1
    Dear PICCman,

    SherlockII can tell if the picc tip is in azygos vein by checking on the depth section on the left hand side on the siterite screen and another detection is the high pitch sound will go off when it is in CAJ.
    If you use sherlock in a large amount of piccs and longer period of time, I'm sure, you will love the sherlock as your buddy.
    I can tell you that Bard salesreps and bard clinicians don't even know sherlock as much as I know it. Why? Because I have used sherlock for more than thousands of piccs since it just came out of the market.
    That's another perspective of utilizing the technology in the millennium.
    Good luck!
    AAchoa1,

    It is good that you are able to identify the tip in the azygous vein but other bard users say that the sherlok does not identify when the tip is in the azygous vein. I do not doubt that you know what you are doing but as far ar Bard is concerned and the whole community of PICC line nurses your technique becomes questionable. I own a small company that does 400 PICC a month and i have revised the PICC insertion upside down based on how INS trained me 18 years ago. I have 15000 patients worth of data but does these data hold any proof , no because i have not published them. Same as yours If you have the data to prove it works you should sell it to bard. I think
    it is great that you are an experienced user of sherlock. By the way the last time i spoke to the regionl manager and sales rep of bard in my area, they told me it does not identify when the tip is in the azygous vein so i encourage you to come up with a research to prove your tehnique is correct and dependable. It could make you a millionaire. And also convince them to standby their product by convincing the medical community especially the rads that the findings of sherlock and navigator are worth using. I use the navigator and each wire cost me 41 bucks. It helps me with my time management coz i am able to see more patients and not wait for a chest xray. Once in a while i have this azygous tip placement but my machine says it is in the direction of the SVc region. I prefer to use the navigator coz i service 9 hospitals and 250 nursing homes and they use 5 different catheters. The navigator is universal in use whereas bard sherlock is not. In truth, 98 % of my PICCs will go the direction of the SVC region. The other 2 % is either you cannot get to the SVC because ethey have history of multiple subclavians, or their is a dialysis catheter blocking the inominate/SVC region and in these cases you cannot place the tip in the SVC so what use is the sherlock and navigator. It would be good for us PICC nurses if the report that sherlock/navigator gives will be acceptable to the medical commubity. Could you believe i do not have to wait for the rad techs which by the way sometimes takes a little while. I would love to hear more from your experience and if were in my area i would love to hire you.


    picclineman NOT piccman
  4. Visit  picclineman profile page
    0
    Quote from achoosa1
    I use navigator too. but I'm not a big fan of it because I don't like to exchange & reinsert the stylet in the PICC catheter. Moreover, there is more risk of getting contamination from putting the corpak stylet in the Navigator unit which requires a sleeve to cover the whole unit.
    Pacermaker patients are contraindicated for using Navigator, Per the Navi manual guide opposed to Sherlock. Sherlocks could be used with the pts with pacers.
    i was given a memo from navigator that says it is not contraindicated for pacemaker. I did try it on a patient with pavemaker and the aptient was ok. So update your info.
  5. Visit  piccme profile page
    0
    I use the Sherlock with every insertion. I wouldnt want to do piccs without it, actually. I know exactly where my picc is all the time. Bard has a deal with the shelock, our initial one was 1500, but if we maintain 40 piccs a month they will reimburse us the full cost.


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