GailAnne

GailAnne

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About GailAnne

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  1. A short PICC line ?

    I agree with Texas! and IVRUS, the subclavian is totally inappropriate, as is using a PICC as a midline. This leads to potential confusion and complications. There are midline catheters and they should be used as such. Why use a PICC at about 3-4 X t...
  2. SQ Lidocaine Administration/PICC Placement

    We also use a 5ml amp but use a 1ml syringe. I rarely give more than 0.4-0.5 ml. We do have a spare needle incase we need to freeze in another area, either because we change our approach or have to go to try #2. Since the main point is to freeze for ...
  3. How to deal with catheter issue when insert a PICC line.

    A couple other things to consider..... Some types of catheters will want to go north, or contra-laterally at first. Just use a little patience, it seems they are more pliable as they warm up in the body. I've seen a Rad use the heartbeat to judge whe...
  4. Question about PICC insertion experience

    It can take anywhere from 30-100 PICC insertions before people feel truely competent. Remember, it's not so much of an issue when things go right....it's the ability to quickly run all the possible senarios through your head and deal with the times t...
  5. Flush and blood return

    To look at this very simply, a PICC is a pipe, if it's clogged or partly clogged, then the fluid will either go down very sluggishly, or not at all....no different than if the pipes off your kitchen sink are clogged. The kitchen sink either doesn't d...
  6. New PICC nurse needs help......PLEASE

    You may want to check out IV-Therapy.net as well as this site. g
  7. New PICC nurse needs help......PLEASE

    Do you mean that you have only tried 4 PICC insertions total? If so, aren't you still working with an experienced PICC insertor? Yes, you are correct to remove needle from an artery ASAP and hold pressure for quite some time (10 minutes can be used a...
  8. PICC placement for a pt with high INR

    Another agreement with the last 2 posts. In fact I just, this week, inserted a PICC on a person who was at 5.4. Barely bruised. Of course, the brachial vein wouldn't be top choice on these people! I'm more concerned with low platelets than PT/INR, I'...
  9. PICC Placement

    Is the rad saying it is "in" the azoyous vein or "at the level"? It looks like they are saying "at". That's similair to saying at the level of the corina or at the level of T7 for example. If this is the case, maybe you could explain that it gets con...
  10. IR *wants* to place PICC's.. now what??

    When you say that you are "interested" in PICC insertion, do you mean that you are not currently trained? It takes anywhere from 40 to 100 insertions to feel really comfortable with all that can happen. Setting up on your own also means having an Ult...
  11. PICC Line Certification Course Info Needed

    You may want to try a private course, such as through PICC Excellence Inc or Lynn Hadaway Associates Inc. There are others as well. Try looking for links on the AVA or INS sites. Good luck
  12. picc line & blood clots

    Motdog, it's great that you have an ultrasound, with use of Basilic (and then Brachial at times) veins away from the ACF, you should see a drop in the rate of thromous. We rarely have a known thrombous, is your rate of 7.5% actually backed-up by dopp...
  13. Problem with blood withdrawal Hickman Line

    First question would be, where is the tip? Is it really in distal SVC or RA/SVC? If it's back at a curve it could easily be up against the vein wall. (which also means you are giving the TPN against the vein wall) What size is the catheter? Hopefully...
  14. PICC lines and Dilantin

    Dilantin and silicone PICCs are a problem (can't speak for polyurathane ones). I've seen them turned to cement with one dose, regardless of flushing, when a minibag is used. If you MUST use the PICC, give the Dilantin push with extra saline pre and p...