piccman

Eric, you just beat me to it. I was just about to post THE EXACT SAME THING! Personally, I don't care if either is/isn't a word. They Both annoy the cr#p out of me.

I agree with the sonimeter. Drives me nuts. And let's also not forget "orientated"

You women all make me sick. There is only one correct answer to this question.......and it is Alyssa Milano (with long hair). Period.

I frequently place PICC lines by placing a 1-1/4 in Protect IV in the basilic/cephalic vein with ultrasound and then using the MST wire and so forth. I do this mostly with medium to large vessels. There are times with the MST needle, when that darned wire simply will not thread, no matter what angle one is at, or if you keep the transducer on the site or not, or whatever. When you place an IV, THE WIRE IS GOING TO THREAD, period! What's interesting is that sometimes I can see the IV much better on the US screen than the MST needle, and other times it is completely the opposite. I'm not sure why that is. As far as using IV's to place PICC lines, I think it is perfectly acceptable. After all, the kits we use come with 20 gauge 1-3/4 in IV's already in them. And I do occaisonally use them if the vessel is more than 1 inch "underground"--so to speak. Heck, I even use 22 gauge protects every now and then. sam

In my experience, a higher HOB angle does not always increase chances of PICC threading to the SVC. I actually lay to about a 5-10 degree HOB angle before I thread the PICC past the shoulder. I USUALLY have better results with this approach. sam

Infusion nurse standards state that you use the smallest size iv that will get the job done. I place many piccs and am on the iv team and it never ceases to amaze me how many nurses think you HAVE to have an 18 to give blood. That's ridiculous. Now, if someone is a trauma or gi bleed or something along those lines, then by all means they need large bore but most pt's simply DO NOT. For most pt's, a 20 or 22 is more than enough to get the job done. I frequently see iv's go bad and infiltrate or get phlebitis because someone stuck an 18 or a 16 or even a 20 in a vein that was simply too small. To whoever stated that smaller iv's cause more discomfort when giving Vanco.....WHAT??? That is completely wrong.

For your son's sake, I would recommend you reconsider this decision. In the US the majority of boys are circ'd and it is not a nice feeling to be the only kid in gym class who looks different. It can lead to teasing and a lot of embarrassment. To this day I almost never am naked around my wife (together 15 years or so) for the simple reason that I hate that I look different. I will never forgive my mother for not having it done. Yes I could have it done now but I have read some horror stories online about complications when it's done on adults and that has deterred me so far. He won't remember it and he will thank you later. I guarantee this. You might find some female nurses here that are against it, but I assure you that most women in the US find the circ'd member more attractive, and many find the un-circ'd one simply gross. You are doing your son a disservice, imo, by not having this procedure done. Is it medically necessary? No. Will it make your son more attractive to a MAJORITY of women in the US? Yes. And any woman who disagrees with this statement on this forum is clueless. just my 2 cents. btw this is my first post on this site, I usually just lurk, but I feel so strongly about this subject that it actually prompted me to sign up. piccman