For those that have CXR taken for patients arriving with a PICC already in place, how do you manage the serial patients? A previous list serv showed that they are considered in use and a CXR will not be taken. The question has now come up, is there a time frame of when the PICC was last accessed? What exactly defines a serial patient? Your assistance is greatly appreciated. Thank you. Yvonne Cales, SMH.
Very sorry but I do not have any idea about the question you are asking. I don't understand how you are using "serial patients". Can you be more descriptive of the situation you are asking about? 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
Thank you, you answered it and so did the other person.
Yvonne K. Cales
Sarasota Memorial
Serial patients are treated as outpatients and once placement is established we don't re-xray until we have a problem such as no blood return or difficulty infusing.
BJ Sherman, RN
Vascular Access Coordiantor
I think you question is about secondary malposition of the PICC tip location and how frequently should a repeat xray be done to confirm correct tip location. Secondary malposition, along with primary malposition, are both addressed in the Infusion Nursing Standards of Practice. Secondary malposition is a sporatic, unpredictable event when the tip of any CVAD can move from its original location into a suboptimal location. There is no time frequency that will predict when tip migration has occurred. The standards called for all nurses to know the signs and symptoms of tip migration or this type of secondary malposition, refrain from using the CVAD until the tip has been returned to its correct location. When you are talking about hospital admission with some type of CVAD in place, especially one placed at another facility or where there is no record of the original tip location, most facilities will obtain an xray at admission. Others choose to rely only upon signs and symptoms of malposition. I can't help with your "serial patient" definition, sorry. 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