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Chris C

I am wondering if anyone out there is using the Pacerview tip locating system.  Do you like it?  Is it reliable?  What kind of cardiac monitor are you using with it?

Thanks,  Chris C  Mesa AZ 

Glenda Dennis
I am using the Pacerview
I am using the Pacerview and I like it very much.  I find it easy to use, very reliable, and cost affective.  It doesn't matter what kind of cardiac monitor you have.  I have used the monitors in ICU and a small portable monitor. Three or five lead systems are both fine.  It only works with open ended PICC's however.  With Groshong ended PICC's, the wire is insulated from the electrical inpulses.  It only takes a few insertions using ECG guidance to get comfortable with it.  I would encourage you to contact Dr Rothenburg and try this technique. 
Anybody else using this

Anybody else using this Pacerview as a tip locating system? Please post your experiences.

Glenda, how long have you used this system?  Are they allowing trials for this system? Are there consumables involved?   If so, how much?

Are you still getting follow
Are you still getting follow up x-rays??
Glenda, You said it is cost


You said it is cost effective, does this move you away from doing any chest x-rays? How does this product stand as far as regulatory requirements are concerned (FDA)? Could you please email me [email protected]?I want to understand more regarding this technology. Thanks.

Angelo M. Aguila, MSN, RN, VA-BC
Vascular Access Nurse
[email protected]

It seems like it has limited

It seems like it has limited value in practice if it only works with open ended PICCs and you need a cardiac monitor available.  Comments? (I am sure we will hear from the maker)

Rich Lewis, RN

Rich - ECG guidance is a

Rich -

ECG guidance is a technique and the PacerView is a simple device used to perform it. ECG guidance, used in the appropriate clinical circumstances, is more accurate than surface landmarks (the foundation for both the "low-tech" tape measurements and  the "high tech" tip locations systems like the Sherlock and Navigator) and chest x-ray. (see However, ECG guidance depends on: 1) A sinus rhythm - it uses the ECG emitting from the sinus node as a beacon. Patients with atrial fibrillation and pacemaker dependence do not have such a signal; 2) The ability to sense that signal - Generally, the signal is detected by a guide wire or conductive fluid (usually blood or saline contacting blood). If your conductive material is enclosed in an insulated, closed system , it can't detect the ECG. Likewise, if your guide wire is insulated, there's no conductive material to contact the metal of the Grabber and no signal sensed; 3) A means to display the signal - Some of the ultrasound machines you use for vessel location (e.g., Sonosite) have ECG display capability as well. ECG machines with real time display are widely available in hospital cardiology departments. Some hospital administrators and PICC placement services are finding the cost and time savings of fewer x-rays and expedited placements make the investment in  a monitor worthwhile.

ECG guidance is one of many techniques available to improve the accuracy of blind CVC placement - Using a tape measure is one, navigational systems another, fluoroscopy or echocardiography yet others.  WHEN APPROPRIATE,  ECG guidance is inexpensive, gives real time feedback, and is highly accurate. Our experience and the experience of our users that have shared this information with us has been that it is useable in the majority (over 90-95%) of PICC candidates in terms of cardiac rhythm. In my geographic area, closed end catheters or insulated guide wires are in the minority. Nevertheless, whether it is usable in 20% of your cases or 90%, it is for you to decide whether the cost and time savings on those occassions makes it worthwhile to have it available to you.

Kathy - Your answers not already addressed above should be sitting at Bard Access headquarters in Salt Lake City - see

Kathy Kokotis Bard Access

Kathy Kokotis

Bard Access Systems

I am curious

What percentage of patient's will this not work on? 

AFib and pacemaker what is you experience?

If you are doing follow uo x-rays what is the success of proper positioning you have seen with this technology?

This is a very exciting technology to improve patient flow for the future as we move into healthcare changes in 2009/2010  The world is going to greatly change in the next two years


Kathy Kokotis

Bard Access Systems

Glenda Dennis
Since I have been using the
Since I have been using the Bard Solo PICC, I use ECG guidance with all patients without atrial fib or a pacemaker.  I have presented this technique to the medical staff and find the internists and cardiologists are impressed and excited about the fact that I can complete a PICC placement using ECG guidance in about 30-45 minutes.  The surgeons have some difficulty understanding the concept.  I have not yet received permission to forgo the chest x-ray but am usually confident enough of where the tip is that I usually dress the PICC before the chest x-ray is done.  I document using the ECG strip as well and the chest x-ray. 
Glenda Dennis
Just an update on my use of
Just an update on my use of ECG guided PICC placements.  I have been doing this procedure with medical staff approval since January of 2009 without needing a chest x-ray for confirmation of PICC tip location.  I often check to see if the patient has received a chest x-ray later in their stay which confirms my initial placement.  It is saving patients money and radiation exposure and is saving my hospital money.  It is a significant time saving procedure for me as well.  I document tip placement with a monitor strip obtained from the PICC tip using the pacerview. 
Hello Glenda - can you
Hello Glenda - can you please share with us your process for getting your hospital to approve this practice?  I would very much like to do this at one of my facilities, and I don't know where to start.  Thanks!
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