Lanurse0417

The types of patients varies some are critical but the majority tend to be for access, some maybe for TPN or IV access for dc patient home on long term abx. For the most part we really don't give the nurses and MDs a hard time about the emergent ones but more so the patients that have been there a week or so already and on 4pm sat afternoon it is Stat cause they lost their access!! We do have a protocol but its not being followed and we do keep up with callbacks also. MDs hardly ever place cvls anymore cause they can just say get a picc line and they can call us in....just wondering how this is handled in other facilites and if its the same everywhere cause they are running us ragged for sure!!

Help!! I work at a 250 bed hospital on a PICC line/IV team in which we are on call for after hours picc line insertions. Our normal hours are 8-4 with call backs the remaining hours. We get called at all times throughout the night and even on the weekends several times a day. We have a protocol in place in which nurses should assess their patients and call only if neccessary and attempts have been made by anesthesia and supervisors ect. I need to know what other hospital policies are involving call back and after hours insertions. I dont think that picc lines should be an emergent procedure like they are being treated here. Please any help would be appreciated.

Anyone ever use the dual lumen repair kits that Bard makes. We have ordered them but they look very complicated just wondering if anyone had any experience with them. Thanks...

The few patients that I have seen these done on were in the unit before and after the procedure. I know I had monitor pressures and was told that once a patient died on table during a TIPS (patient was already really sick). We dont do them very often, only 2-3 of our docs will do them cause it is so risky. Hope this helps.

We have been doing the cardiac CTs for about 3-4 months now and I am also fairly new to the protocols. We have the patient come in the day before for a preassessment and check all their vital signs as well as their medical history and medicines. According to their resting HR we give them PO Lopressor to take home with them. Usually 50-100mg unless their HR is already at the desired rate 50-65bpm. If they are asthmatic (beta blocker contraindicated) we give them Verapamil 240mg when they get here the next day and monitor them for an hour before the exam. They take the Lopressor an hour before their scheduled exam. When they arrived we check their HR and BP and if HR not below 65 then we usually give another 50-100mg of Lopressor depending on current vital and body mass index. They are then monitored for another hour. If after that hour their HR is desireable then we can scan them if not and vitals are still stable we will sometimes administer Lopressor IV 5mg every 5 min X 3 doses or until HR is at desired rate. Usually we dont resort to the last, usually the first home dose is enough and the rest is not needed but we have used it a few times. We usually do not give more then 200-250mg PO or 15mg IV all total.

Ok here goes....not sure whether or not my answer is legally the right way to do things, i can just say how we do it. We have I guess moderate sized hospital (about 200 beds). We place the picc lines in IR there are two nurses and two rad techs. We do most of our picc lines without assistance from the radiologist (b/c we do more of them we are better at it then they are). We do them under fluro if the patient is able to come down to the dept, if not we do them at bedside. All four of us are trained in putting the picc lines in. The radiologist is not always present when we shoot the fluro to check them, but most always the rad tech is there to help us with shooting it if we needed help (but we could do it also without them). Like I said not sure how legal it is but it is just the way we have always done it.....

I am a nurse in radiology at a moderate sized hospital. I guess there are about 200 beds or so. We get paid $3 an hour for call pay, and then time and a half for call back. We get the first hour automatically when we clock in whether or not we are there for an hour(makes picc lines a breeze). There are only two of us(nurses) in the department so we alternate call 7 days on and 7 days off. Hope this helps.....