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Jeff Black
Advancing the wire
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
RBR
I'm not to sure about the
I'm not to sure about the wire curling up, maybe your angle needs to be changed when entering the vein. I try and rotate/twist my micro introducer when I'm advancing it into the vein. It seems to work well for me. Good Luck!DM
Gwen Irwin
Are you using ultrasound to

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

 

stemc
When we insert the guidewire
When we insert the guidewire we feed it through until we are past the end of the needle if it is going without difficulty we break off of ultrasound and advance.  If it is tough then we adjust our needle a very small amount and try the guidewire again we do this until the guidewire is going past the end of the needle easily.  We have had great success with this.
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