Any techniques to place piccs in obese patients. They have very large arms which I use a 7cm introducer kit but the veins are very hard to enter, thread the wire due to the depth of the vein. I cannot flatten out the introducer to place the wire and if I don't the wire gets caught on the needle or bends in the vein.
Jan 5, '07
I have not noticed a difference in the veins themselves of obese patients versus others. They are obviously deeper but a 7cm kit should more than suffice. I would suggest not using a needle guide on the deeper veins--it gives you too straight of an angle through the tissues and into the vein. Changing your angle of needle insertion should help with both the difficulty you are encountering threading the wire and getting the introducer in.
Jan 7, '07
thanks for replying. So do you use the angio cath instead like the 20g in the kit?
Jan 7, '07
No,needle only for deep veins. Typical angiocath in the kits wouldn't be long enough. I will at times use a 22ga angio for very shallow (<0.75cm) veins on very small or very thin arms,the opposit end of the body buils spectrum.
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