Hello - I was wondering if anyone out there has a reference for the practice of checking the IJ with ultrasound for the presence of a malpositioned PICC? Our clinicians have been doing this for a couple of years, and we were recently asked for a reference. Like many things that seem sensible, I realized I've never seen any published literature on this practice! Thanks for any help. Kris Gundrum, AccessRN
Hey Kris
Have not seen any published data, however, Angiodynamics and Jack Ingold covered this very well at AVA this past year. Basically, when looking at the IJ with your ultrasound, you can actually visualize the white catheter inside the vessel. If you are able to flush while you are looking with the ultrasound, it appears on the ultrasound as sparkly or snowy. If you would like, email me and I will forward your contact information on to Jack, I think he has a ppt presentation that may touch on this topic. [email protected]