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Fri, 10/12/2007 - 16:58
#1
smarison
IJ Picc reposition
Ok so my staff is insistant on if a Picc is in the IJ, they pull back 5cm or whatever seems to be appropriate, and then they re put that 5cm back in the patient, after cleaning the site again of course.  I know this is not OK practice but have heard others do that also.  I have always been told to never reinsert a PICC.  Even though this is a newly placed Picc, Xray has been before and even with recleaning it doesn't seem OK.  Anybody have an articles or any info to back me.  Thanks Susan
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Mon, 10/15/2007 - 15:08
lynncrni
You are correct - after the
You are correct - after the original sterile field is gone and the PICC has been in contact with the skin for any amount of time, there should never be anyway withdrawal and readvancement. So how are they dressing this line between insertion and knowing the tip location? This is the issue.  This is the reason that we have been so creative through the years of repositioning a PICC that has turned up into the IJ. First we started with the power pushing through this PICC- patient sitting up and flushing with 20 to 50 mL of saline to force the PICC downward. Then some decided to leave the wire inside the catheter, encase the entire external catheter within sterile 4X4 gauze pads and get the chest xray immediately (nurses making inital assessment of tip location) then repositioning if required. Then the concept of allowing time and normal bloodflow to spontaneously move the PICC to the SVC then repeating the chest xray. Now US is used to rule out IJ tip location before the sterile field is broken. Lynn

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

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Thu, 10/18/2007 - 13:01
Heather Nichols
      Have you thought

 

    Have you thought about trying a Navigational Device like Navigator or Sherlock to avoid this practice and the multiple x-rays and set ups?  It can save you a ton of money!

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