sbivrn

sbivrn has 18 years experience.

Latest Activity

1. PICC programs

   sbivrn replied to PICC RN's topic in Infusion

   CRNI stands for Certified Registered Nurse Infusion. To become a CRNI you must currently work in one of the nine core areas of infusion nursing, and pass the certification exam. Not all CRNI's place PICC lines. This is a national certification by the...

2. Head position in PICC placement

   sbivrn replied to blsmom's topic in Infusion

   Interesting. I place the patient completely supine, except in cases where the patient cannot tolerate it. When making the turn at the shoulder I have the patient turn their head toward me and angle the chin down to the shoulder. This almost always wo...

3. opening clogged PICC, with a wire????

   sbivrn replied to SWAT_RN's topic in Radiology

   Sure, but it's taken us to some neat places :)

4. opening clogged PICC, with a wire????

   sbivrn replied to SWAT_RN's topic in Radiology

   Perhaps I have been unclear. I do not do over the wire exchange for clotted PICCs. The result would be no different than that to which I am objecting. Our two options are to use Activase to declot the picc or to pull it. Never to stick a wire into it...

5. opening clogged PICC, with a wire????

   sbivrn replied to SWAT_RN's topic in Radiology

   Over the wire exchange of a PICC line is a totally different issue. The validity and safety of the procedure is well documented. We accomplish this quite safely at the bedside. This is also done in Radiology. You cannot compare declogging a g-tube wi...

6. Student asking: "What's your background and why IV nursing?"

   sbivrn replied to Chaetognath's topic in Infusion

   The first couple of years post nursing school can be overwhelming. They just cannot teach you everything you need to know. so you will get quite a lot of on the job training. As bad as it seems on new grads, it's much better these days. I started out...

7. Student asking: "What's your background and why IV nursing?"

   sbivrn replied to Chaetognath's topic in Infusion

   Just saw your question. You can certainly make a career out of vascular access nursing. It is much more than running here and there starting IVs. I am not aware of any specialty IV teams that will hire a new grad, however. Most will want a few years ...

8. Midline venous catheters

   sbivrn replied to cannulation's topic in Infusion

   Lots of luck to you. Love to hear about anyone making new strides in vascualr access for their institutions. You're doing a good thing!

9. Midline venous catheters

   sbivrn replied to cannulation's topic in Infusion

   I don't believe you'll find any articles on blood draws from midlines. I am not aware of any. We do not do blood draws. Maybe I was unclear. We check for a blood return upon insertion. Then flush really well with NS.

10. Midline venous catheters

    sbivrn replied to cannulation's topic in Infusion

    Yes we do use blood return as an indicator of satisfactory placement. We do not xray midlines. We typically use (on the adult patient) 4 french single lumen catheters for midlines, cut to have the tip locate in the axillae. We will flush afterwards w...

11. opening clogged PICC, with a wire????

    sbivrn replied to SWAT_RN's topic in Radiology

    I agree with Diana. Where did the clot go if not into the patient's vascular system? This is not an INS standard of practice. This should not be let go. Many people cover a lack of knowledge with bravado! :)

12. PICC programs

    sbivrn replied to PICC RN's topic in Infusion

    I am very proud of the IV team of which I am a part. We are a part of Gaston Memorial Hospital in Gastonia, NC. There are 9 of us and 7 of us are CRNI's. We cover the hospital 24/7. We place 150-180 PICC per month. We place several hundred difficult ...

13. Midline venous catheters

    sbivrn replied to cannulation's topic in Infusion

    That's interesting. Do you place midlines in the same manner as PICC lines? We use the modified seldinger technique for both and don't have anymore problems with bleeding from one to the other. It usually depends on the bleeding times and whether or ...

14. Starting IVs on old sick people

    sbivrn replied to zacarias's topic in Infusion

    Those are hard ones, no doubt. You are dealing with poor skin tugor, probable dehydration, and poor venous status. Just make sure you are not using a catheter that is too big. A 22 gauge catheter is plenty big for most infusions. Forget what they tol...

15. Picc Question...technique

    sbivrn replied to blsmom's topic in Infusion

    Wow- I've never heard of trying that. Do you mind telling which brand of picc needle is giving you the trouble threading the wire?