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karrenberg
pacerview

PMRMD has posted on this forum several times re: pacerview for tip location.  Has anyone used this.  Lynn, do you have any opinion on this or know anything about it.    Thanks

lynncrni
Sorry I only know what I

Sorry I only know what I have seen from their website. It does not look very user-friendly to me from the pictures. But I have never actually seen it. I don't think this company has ever had a booth at either INS or AVA. So it is hard to really discuss without some up-close and personal exposure. Sorry. Lynn 

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

www.hadawayassociates.com

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

PMRMD
I couldn't help noticing

I couldn't help noticing your question : The technique of ECG guidance has been around for decades. It has been well validated (see http://www.cja-jca.org/cgi/content/full/53/10/978 for a 2006 study showing ECHO correlation with P wave morphology) and commercialized in Europe by BBraun (see www.cvc.-partner.com). If you write me directly at [email protected], I can send you representative tracings from 5 cm above the SVC-atrial junction to 6 cm below it in 1 cm increments and you can see for yourself how obvious the P wave changes are to distinguish.

Although the idea of using a sterile sheath or looking at a monitor may initially seem cumbersome, like any new technique, once you've done it a few times it becomes second nature. There are only 3 steps to using the PacerView: attach the leads to the patient, attach the Grabber to the guide wire, and snap the monitor ECG lead onto the PacerView. With 2 or 3 procedures, you will get a feel for the P waves. Using the sterile sheath for the connector is no more difficult than using it for your ultrasound probe.

Glenda Dennis
I have now placed 5 PICC's
I have now placed 5 PICC's using ECG guidance.  It is very simple and I was able to accurately put the tip where I wanted it to be.  I anticipate doing about 10 more before I have enough data and confidence to not need to do the chest x-ray.  I will document tip location with an ECG strip.  This means many fewer chest x rays and considerable time savings.  In this climate of watching every expenditure and saving where we can, this is big!
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