I am having difficulty with successfully placing PICC. The biggest problem is advancing the wire. Many times the wire curls up in the vein. Other times it seems the wire is in the vein the I can't advance the micro-introducer into the vein. Any suggestions? Thanks in advance JB
Are you using ultrasound to place the PICCs? We found that during our transition to experience with ultrasound, that there were times that we were not in the interlumen of the vein. These were the times that the wire would not advance easily past 15 cm., because we were not in the lumen of the vein. We were on the outside perimeter of the vein and the wire would curl up or "tunnel" about 15 cm along the outside of the vein.
We found that we were getting blood return (tip of bevel of the needle in the vein providing blood return), but not through the vein wall, to advance the wire into the lumen. Learning for us was to visualize the complete vein wall penetration on ultrasound amd then easily advance the wire.
Hope this helps.
Gwen Irwin
Austin, Texas