I attempted to place a PICC line and the chest x-ray showed the tip in the left IJ. I was told by a colleague of mine that this can easily be fixed by vigorously flushing each lumen using 3ml syringe per lumen. He's had 90% success using this technique. I have not seen any literature or any materials related to this. Does anyone know if this is used at other facilities or has it been used by other PICC nurses?
Bubbles
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
In addition to "propelling" the tip into SVC w/ flushing, it helps to have the pt perform a 'val salva'.
Ask them to take a deep breath, hold it and bare down 5-10 seconds and then tell them to let go fo their breath and at that time push in the saline, as the blood "rushes" back to the heart, it will 'take' the catheter with it.
However, IR and I found out that it is harder to accomplish with the 6.0 French Dual or Triple lumen. We use 5cc or 3cc syringe as long as it is a Power PICC.
p.s I am talking only about adults, Have no idea how to do it with pediatric.