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ACLS required for PICC insertions?
I'm having a bit of a disagreement with the administration here where I work.  Someone has decided that we should require ACLS for all nurses who insert PICC lines.  In my experience, our code team has been called to the hospital cafeteria many times, but never to a PICC insertion, so I think the cafeteria workers should all be required to be ACLS certified.  Does anyone else require this of their IV teams?
Wow, that's one I have never
Wow, that's one I have never heard before! I love your cafeteria worker analogy, here is another one....are all the MDs that insert CVCs ACLS certified?  That procedure has a much higher risk profile, especially if that MD does not use ultrasound to place the CVC.
I work in a 25 bed rural
I work in a 25 bed rural critical access hospital, and all RNs regardless of department, are required to maintain current ACLS provider status-- but again we are very small, no IV therapy department, and any nurse may be called upon to help in a code situation, but usually the ER/ICU staff are assinged to the code team.

Kathy Brown RN, BSN,CRNI

Leann Kennedy
It's not required where I

It's not required where I work...I just have it so if a pt needs to go to IR and they are monitored, I'm a little more comfortable with the situation.  I know, for example, when to watch for potential arrythmias, etc.  It's just my personal thing.

G. Irwin
ACLS required for PICC insertions

I have seen ACLS required for job applications for PICC RNs in the Dallas/Fort Worth area of Texas.  If you don't have current ACLS, you can't apply for the job (that is what I have heard).

I am not sure why this would be required for ECG PICC insertions.  It seems to be overkill.  I keep trying to think of a comparison.  Having a BSN or MSN to be able to insert a Foley catheter is the closest that I can think of.  Can you think of a comparison that is better, if you are a PICC nurse that uses ECG for tip location?

If I am insering a PICC, I am not going to run a code during an insertion.  I need to understand what I see on the ECG and recognize a p-wave and respond to that p-wave changes to adjust the PICC tip location.  I don't need to know when to get the debrillator or to know what drug to give next.  There are other ways to document knowledge about ECG and document competency in recognizing a ECG recognition of a rhythm, isn't there?

What are your thoughts?  Does anyone else in the US require ACLS for PICC insertion? 

I agree that it is as crazy to to have the PICC nurses ACLS competent as well as the cafeteria workers.  What is the result of your situation in Spokane, Jerrbear?



If I am not mistaken I believe Arizona requires it for PICC insertion.  I know for a fact it is required for subclavian an jugular placement by an RN

It can be state specific but it is not common and the guidelines currently from INS do not recommend it is needed

kathy Kokotis RN BS MBA

Bard Access Systems

jill nolte

It would seem to me that any nurse working in a critical area in any capacity should have ACLS and be prepared to jump in when needed.  If the nurse is mostly inserting in lower acuity areas it might not be so critical but it never hurts.  Just fyi, I have had to abort an insertion to code a patient with bleeding esophageal varices.  Too bad the picc wasn't in place earlier, he sure did need it. 

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