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Amy Graham
Leaving the guidwire

My current hospital procedure when placing a PICC line is to stand at the bedside until x-ray confirmation is obtained.   With recent addition of ultrasound the PICC line requests are growing.   It is becoming impossible for me to wait for radiology.   But I am not yet comfortable with dressing the line, in case the line needs to be adjusted.   Does anyone wrap their PICCS in sterile gauze and come back later to pull the wire and dress when x-ray has confirmed  SVC placement. Amy Graham Nutritional Support Memorial Hospital

I have always left the
I have always left the stylet wire in place, wrapped the external catheter in 4X4s and sterile Kling or Kerlix, then sent patient to xray. But we would never allow this to remain in place for long periods. Usually 20-30 minutes was the max. What is your rate of malposition on the first insertion? Use of the ultrasound can eliminate jugular placement and use of the new locating devices and help determine that the tip is in the correct region, although a chest xray is still required before therapy begins through the line. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Gwen Irwin
We don't have time to wait

We don't have time to wait for xray either.   We do the dressing application for single lumens, but on dual lumens, we wait.   We seem to have more malpositions with dual lumens that with singles.   However, there are times when really busy that we don't wait for xray for duals either.

We will be starting to use tip location technology soon.   We are very excited about this and will leave all of them knowing that the tip is in the right direction.   We expect to see more productive time spent responding to the requests for PICCs, instead of waiting on xrays.

We have never wrapped the catheter like described and go back to reposition.

Gwen Irwin

Austin, Texas

Timothy Royer B...
We do the same.
We do the same.
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