Forum topic

4 posts / 0 new
Last post
Constantina K S...
Lymphedema in a bilateral mastectomy patient with peripheral IV's
Had a patient who had bilateral mastectomy with TRAM flap reconstruction and bilateral sentinel node biopsies, her request for a central line was ignored by the anesthesiologist.  When she came to the floor, all we had were peripheral IV's that kept infiltrating and we couldn't control her pain.  Tried to get a PICC line in but the IV team nurses talked the surgeon out of it.  I'm afraid of where this may go and maybe what we should have done?  Any recommendations?
Constantina K S...
Tina Live every moment,

Tina

Live every moment, Laugh every day, Love beyond words.

Tina

Live every moment, Laugh every day, Love beyond words.

lynncrni
Use a PICC to get a small

Use a PICC to get a small size catheter but insert it into a jugular vein. See the INS paper on using the external jugular vein. See an AVA paper on using the internal jugular vein. I would recommend the internal jugular vein with a subcutaneous tunnel so that the exit site is not in the neck. Sounds like this patient should be referred to an interventional radiologist for vascular access. 

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

Timothy L. Creamer
I agree with Lynn, check

I agree with Lynn, check with catheter availablity from the IR vendor for a product like the PowerLine CVC. It is a small bore catheter designed for a short tunnel with a cuff. This type of catheter is ideal for the patient described, as well as patients with chronic kidney disease, or any other PICC limiting factors.

Hope this helps. 

Timothy L. Creamer, RN

Clinical Specialist, Bard Access Systems

Florida Division

Timothy L. Creamer RN, CRNI

Clinical Specialist, Bard Access Systems

Florida Division

Log in or register to post comments