If none of this new technology is available, the only thing you can rely upon is your skill at external measurement to determine the length of catheter to insert, using US to rule out jugular placement before you break your sterile field, then a post procedure chest xray to identify tip location. Even with this technology, you still need the chest xray but this technology gives you an idea that you are near or at the correct location before you break your sterile field. Without it, you must practice as we did for more than 20 years without it. It can be done, but you may have a higher number of catheters that will require repositioning after you get the chest xray results. Lynn
There is no way to check tips, or confirm placement before the CXR... That's the point of the CXR. As Lynn said, you can usually r/o jugular placement. Otherwise it just takes skill and experience.
Actually there is a way to know exactly where your picc tip is without chest x-ray. By using EKG guidance you can know where your tip is and not even wait for a confirming chest x-ray. JAVA is publishing an article on this subject in the next issue. Be sure to look for it.
If none of this new technology is available, the only thing you can rely upon is your skill at external measurement to determine the length of catheter to insert, using US to rule out jugular placement before you break your sterile field, then a post procedure chest xray to identify tip location. Even with this technology, you still need the chest xray but this technology gives you an idea that you are near or at the correct location before you break your sterile field. Without it, you must practice as we did for more than 20 years without it. It can be done, but you may have a higher number of catheters that will require repositioning after you get the chest xray results. Lynn
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
Lynn,Thanks for your advice. I meant check tips prior CXR.
There is no way to check tips, or confirm placement before the CXR... That's the point of the CXR. As Lynn said, you can usually r/o jugular placement. Otherwise it just takes skill and experience.
Mike
Actually there is a way to know exactly where your picc tip is without chest x-ray. By using EKG guidance you can know where your tip is and not even wait for a confirming chest x-ray. JAVA is publishing an article on this subject in the next issue. Be sure to look for it.
You're right, if you have that equipment.
Looks pretty exciting. Went to a inservice on it... very cool.