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ladena rhoden
Double-Wiring

Just heard that some places are 'double-wiring' or putting a 2nd wire into the other lumen of a PICC to give it more body.  The claim is it helps to eliminate coiling.

Can you please share your experiences and opinions on this practice?

dcole
We insert a second when we

We insert a second when we are having difficulty rounding a bend or other threading issues.  We make sure the wire does not extend beyond the tip of the picc.  We keep extra sterile wires just for this purpose so we don't have to open a micropuncture kit. 

 

D. Cole, RN CRNI

 

karrenberg
Where do you get the extra
Where do you get the extra sterile wires?  We do the same thing but I use the MST wire which isn't really long enough.
lynncrni
I strongly urge against

I strongly urge against using an MST wire to be placed inside the catheter or to drive the catheter over this wire. It is not built for these purposes and there have been reports of wire breakage and emboli when doing this. This wire is **only** designed to purchase the vein or in other words to advance through the needle to adequately secure vein entry. An MST wire is then removed along with the needle. It should never be withdrawn through the needle and never inserted into the catheter or have the catheter advanced over this wire. It is not the same as a guidewire or the wires in a true seldinger kit.  

 

Lynn Hadaway, M.Ed., RN, BC, CRNI

www.hadawayassociates.com

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

mary ann ferrannini
We never use the MST wire
We never use the MST wire and reinsert back into the PICC plus It has come into contact with the skin. We keep special sterile wires available in case we have to rewire or double wire or have a second stylet in other word. This is never our first option,and we use it as a last resort. For example we have tried many remedial actions and nothing else is working and we usually have only one arm to work with. It must be a very soft tipped end and never be forced. We have never had a problem...not even one..but we are all a very experienced older team. I think the radiologist told us how to do this as well as the vascular surgeon. 
mary ann ferrannini
We use the Cope Mandril Wire

We use the Cope Mandril Wire .018 60cm  We also use the Denny kit 5.0 ( for dual lumen 5Fr size) with a 65cm wire as a back up.The sheath is 9 cm long and this works well on deep veins. We use these a lot on our bariatic patients because the shorter ones in the kit were not adequate (generally speaking veins deeper than 2 cm). The Denny kit not only has a long wire,but comes with an echo tip needle as well.

 

Margy Galloway
double wiring

I know this is an old topic but I am wondering if anyone knows of ANY literature (pro or con) regarding this practice.
Thanks for your help.

M Galloway, RN, BSN,

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