PICC vs Periheral - page 2

I need some help. I originally post this to the Neonatal discussion but need more feedback. I work in a small Level 3 NICU. Our Neo is an Ols School sort of guy. He is very hesitant to allow us... Read More

  1. by   NicuGal
    My other question is this....do you document all these IV things with incident reports...your risk management should be picking up on this. If they are truly getting over 300 cc a day, I would have to refuse to do it. You must be having some major problems with electolytes and such with that heavy of a load. For a premature infant they should be 60-200cc/kg or higher with certain defects such as gastrocisis or icthyososis or such, then they can go to 350/day.

    Unfortunately, you are stuck with this guy unless you can go to the director of the unit with it. And if he is it, then go higher. There are standards of care, but they vary widely. I don't think that all articles in the world are going to change this guy. Actually it sounds like you have more problems than PICC placement.

    And the shortage for Wydase is because they don't make it anymore...wasn't making enough money for the company.
  2. by   Jolie
    I'm sorry it's taken me so long to find these articles for you, but here goes:

    "Percutaneously Inserted Polyurethane Central Catheters in the NICU", Neonatal Network, vol.18, #6, September 1999, pp.37-45.

    "Use of Percutaneous Silastic Intravascular Catheters in High-Risk Neonates", Neonatal Network, vol.9, #11, 1990.

    The second article was written by Mary Kay Leick-Rude, who was the resource person for PICC lines in the NICU of Children's Mercy Hospital in Kansas City. I worked with her back in the late 1980's and had the utmost respect for her. She was extremely knowledgable about PICC lines, was instrumental in introducing them to the unit, and was responsible for inservicing every single staff RN, NNP, and resident on their use. I don't know if she still works there, but if she does, I would bet that she'd be willing to help you out by providing information, policies and procedures, or whatever you need to get a program started.

    Are you in a teaching hospital or community hospital? If you are in a community hospital, chances are that there would be a teaching hospital nearby that you could contact for information and education on this subject.

    Good luck to you, and thanks for caring so much about your babies!