As an educator for Teleflex, I see many practices.  I would like your input on the following situation. The PICC nurses are injecting AIR into the PICC after it is placed. They do it at the time in the procedure that many nurses inject saline and ask the patient if they hear water or bubbling in their ear. Ever heard of this? What are your thoughts?
Cheryl
AKA fruitloop
My thoughts are this is absolutely nuts, crazy, stupid, I could go on. We now have lots of information about the effect of microbubbles in the circulation. I wrote about this in both my chapters of the new INS textbook and you can find information on my blog about a specific article - http://hadawayassociates.blogspot.com/2008/07/save-small-air-bubbles-for-champagne.html
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
Lynn Hadaway, M.Ed., RN, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I had to read your post 3 times because I couldn't believe it. How could any clinician think this is a good idea?
Mari Cordes, BS RN
Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center
Denelle Oliveros RN, CRNI
Nurse Manager
University Option Care
Columbus, Ohio
one procedure of injecting air is bubble study with echo -- but isn't it a medical act?
not sure how it is justified for line placement
what does your safety committee say about the practice?
I agree with the previous postings. This is not a practice that I would take on as a prudent nurse. From years past experience, patients heard saline flushing post PICC without air bubbles. The value of injecting air in this manner is low and the risk is high. I would definitely recommend a tip locator system, before advocating this weird practice!
Gwen Irwin
Austin, Texas
I am shocked that this is a practice that any prudent RN would use. I have never heard of this practice.
Kathy Kokotis
Bard Access Systems
Some MD taught them this is my guess. Just like the rampant use of stiff wiring that I come accross every day it seems. My suggestion as you work for a vendor is to give this team a copy of the IFU's and inform them that what they are doing is not in the labeled use of indications. I would also review their P/P and see if this procedure is in their P/P. If it is not they are performing a procedure not santioned by the hospital. That is the best you can do.
Kathy
Kathy Kokotis
Bard Access Systems
I'm with Mari - I had to read this 3 times too. I can't believe someone would be doing this practice - even if an MD showed you this. Reminds me of what our parents used to always ask us - if your friend jumped off a bridge would you too. Even in the instances of a bubble study during an echo, it is done with a physician present and in a controlled setting with probably much less air that they are injecting through this picc line.
Wow, unbelievable.
As an educator for Teleflex, I see many practices. I would like your input on the following situation. The PICC nurses are injecting AIR into the PICC after it is placed. They do it at the time in the procedure that many nurses inject saline and ask the patient if they hear water or bubbling in their ear. Ever heard of this? What are your thoughts?
Cheryl
AKA fruitloop
[/quote]In my case, I believe a MD showed him to do that as well as read his own Xrays. Too funny cause IN doesn't allow that...............I could go on, but I will leave it at that.