After trialing the Vasonova, I was not impressed . We did not achieve the bulls eye but cxr showed tip location in the lower third of the svc or in caj. My question is this: When the PICC catheter is too short to reach the caj with these location devices, what next ? Are they saying the catheter needs to be replaced? I get tired of hearing about perfection. We work in the real world and every single line is not going to be exact.
Replacement of the PICC would depend upon how far off the caj mark it really is. If you are in the lower third of the SVC, but have not quite reached the SA node, you are probably ok. Any higher than that in the SVC requires replacement with a longer catheter. Catheters left in the middle or upper portion of the SVC are associated with greater risk of secondary tip malposition, thrombosis, etc. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
The "bulls eye" is a calculated algorythm based on the doppler and EKG. It is a helpful tool but the EKG and the doppler give the really important information. If the doppler flow is nearly equal above and below the baseline and the p wave is about the same size as the QRS, you are in good position. It takes a bit of time to get the hang of it but truely is an excellent tool. We love it!