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Sherlock VS. Navigator Tip locator system
Hello!
I would like to get some feedback from those of you who are using either the Sherlock or Navigator tip locator.                        Some of the issues I'm interested in are as follows:

1. Which System
2. How long it took to learn
3. Accuracy or inaccuracy
4. Ease of device use
5. How much time to set up or add to PICC insertion prep time
6. Likes or dislikes of the system

From what I've read, the Navigator can be used with any PICC. The only items needed are the Navigator device and the sylets.
The Sherlock has pre-loaded PICCs that need to be used and need re-calibration of the system before re-advancing PICC. 

Thanks in advance!
Raquel M. Hoag, CRNI
PICC Program Coordinator 
Washington Hospital
Fremont, CA


Wendy Erickson RN
Please respond on this forum

Please respond on this forum - I would like this information as well.

Thanks!

Wendy Erickson RN
Eau Claire WI

estevens102206
1. Which System:  Navigator
1. Which System:  Navigator and Sherlock
2. How long it took to learn: the inservice was about half a day and I felt comfortable with this system within two or three placed PICCs. The Sherlock I thought was very cumbersome and real pain to calibrate. I was also not comfortable using the Sherlock when a patient had a pacemaker.
3. Accuracy or inaccuracy: Navion gave me great accuracy on where the tip is. The sherlock only let me know if the PICC was headed down towards the SVC.
4. Ease of device use: Navion is very user friendly, but you do have to insert the wire.
5. How much time to set up or add to PICC insertion prep time: the Navigator I think is much quicker because you are not having to calibrate the system or making sure the screen is positioned.
6. Likes or dislikes of the system: I like being able to use any PICC with the naigator. With the Sherlock you are tied to Bard PICCs only.

 

 

Eric

Eric

Heather Nichols
Raquel,     1.)  My team

Raquel,

    1.)  My team has used Navigator for about the last 6 years.  We have all tried Sherlock, but we do not use a Bard catheter, so we not only did not like the hassle Sherlock gives you, but we also could not get it without switching to Bard.  We like the catheter we have. 

    2.) See number 4.

    3.) Accuracy.  If I am able to see a CXR before placing the picc, I can be exact with my tip placement.  If you cannot see a cxr, it does not matter, as Cheryl said, just visualizing the chest externally gives you a good idea where the tip should be located.  Navigator will also help you locate where you are going off track if your catheter is not going in the right direction, so that you can position your patient accordingly to help get to the SVC.  It is a life saver. 

    4.) The original developer of the Navigator came in, demonstrated it on a table, gave us 10 wires, and told us to call him if we liked it.  We received no inservice or training.  We used all 10 wires the first day, with no problem, and by the end of the week, we knew we could not place picc's without it ever again!  ;-)

    5.) About 5 min if that.  It is the time you save that is much greater. Not to mention patient and inserter comfort.

    6.) We love the Navigator.  I wish it had a different kind of sound, maybe a musical tune, and I wish the stylets were marked with measurements, but other then that, all I can say is that I really would be hard pressed to work without it anymore.  Kind of spoiled I guess.  Hope you try it!  I gaureentee you will love it.

 

Heather Nichols RN BSN CRNI

 

 

 

Jan Wesselink
1)  I've used both systems

1)  I've used both systems at FL Hospital

2)  Both are easy to learn

3)  see #4

4)  The Navigator can be moved over the body, so if you don't get a reading you can 'go find it'.  If the sherlock needs to be moved, it means potentially disrupting the field since it is underneath, also if moved, it needs to be recalibrated.  To recalibrate, the PICC needs to be pulled back to the arm so that the machine doesn't disregard it.  

5)  The Sherlock will read the other wires also, including the Navigator wire

6)  I preferred the Navigator.

Heather Nichols
Jan,    I do not see how

Jan,

   I do not see how it would be possible for the Sherlock to pick up a Navigator stylet since they work opposite of each other.  Are you sure it was a Navigator stylet you were picking up.  The Sherlock sensor that sits on the patients chest picks up a magnetic field.  The Navigator stylet does not put out a magnetic field, the Navigator itself does that.  That is weird.  That is why we never trialed Sherlock here at U of L.  Bard will not sell you a Sherlock wire for any catheter but their own, and we do not use a Bard catheter.  It would be nice if they were interchangeable, but they can't be.

Heather 

 

Jan Wesselink
Actually, it happened quite
Actually, it happened quite by accident.  We had access to both products, and someone used the wrong PICC with the system they were using.  We were surprised to see the line coming into view on the Sherlock, also.  Correct placement of the PICC was confirmed with CXR.  A fluke?
fentanylius
Very interesting question. I

Very interesting question. I trialed the Navigator and I think this is the most unhandy equipment. Yes you can use it for all the lines, but most of the mistakes are made during the replacement from the Nav guidewire. To keep a nice clean field and putt the probe cover over the nav is a challange. t is not true you see only the line in the SVC with the Sherlock. If you place it in the right spot you can see where the line goes. The plus with the sherlock is you can see during the procedure what's happen with your line and not after the procedure. Yes, it is easy to follow the signal with the Nav and you need a little bit more time with the Sherlock but it is ok. Yes you have to use the BARD Piccs.

Everyone has his "like" or "dislike" thing. Everything is just a question of your set up. Maybe you need 30 seconds to scan, maybe you need 2 min because you don't know where the tip is. Yes you follow your tip with the sherlock and you search your tip with the Navigator. See, I like the sherlock more because I used both. Do what is the best thing for you and most comfortable for you and your team.

Andre Schotte, RNVascular Access ServiceRiverside County Regional Medical Center26520 Cactus Ave, Moreno Valley, CA 92555
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