We recently had a Clinical nurse Rep. come from a different company for training on a non-ECG product and while she was here she was discussing where to leave a PICC tip in regards to height of P-wave. She encouraged us to leave the PICC at the first sign of No deflection rather than where the tallest P wave was acheived. It is my understanding from BARD training that the PICC is to be left at the tallest P-wave without deflection. The BARD/BD IFUs state was is printed below. What is everyone elses take here? I'm not sure what to do because now we have our clinicians doing different practices depending on whether or not they bought into her instructions.
Fri, 08/28/2020 - 00:56#1
P-wave with Bard/BD ECG technology
The Sherlock 3CG+™ TCS displays an ECG signal detected by the intravascular and body electrodes, which can be used for catheter tip positioning. In patients with a distinct P-wave, the P-wave will increase in amplitude as the catheter approaches the top of the cavo-atrial junction. As the catheter advances into the right atrium, the P-wave will decrease in amplitude and may be biphasic or invert