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Post PICC insertion orders
Hi everyone,    In your facility how do you write your post-insertion orders for x-rays, flushing and dressing changes?  Do you group the orders and use one doctor (the ordering doc) or do you separate the orders between radiology, ordering doc and standing orders?   I appreciate any feedback that you can give.    Thanks, Kristin Smith
Rob Burr
Our facility uses a very

Our facility uses a very nice "request for PICC placement" order set which includes both pre, and post orders. Our radiologists had refused to "clear" a line for use, so the order also says "Line cleared for use if tip placement is documented as SVC or CA junction", this allows us to use the line based on the radiologist report, but under the ordering MD's direct order. We also included the post placement CXR, routine flushes per protocol, and thromoblytic agent for declot PRN per protocol. Works well for us.

Good Luck!

Gwen Irwin
We have medical staff

We have medical staff approved PICC insertion orders, that include pre and post PICC.  Radiologists didn't want to give us an order to use.  The PICC insertion orders say "may use PICC when the tip is confirmed in the SVC.  The tip is confirmed to be in the SVC by __________."

We fill in our name after assessing the tip location on x-ray.  Our radiologists supported our education and training for determining tip location.  Makes for much quicker turn-around time to use the PICC.

 Gwen Irwin


teri stevenaon
Hi.  We have a medical

Hi.  We have a medical committe approved PICC order sheet that includes pre and post PICC orders, drssing changes, flushes, and care and maintenance.  As with the others, The radiologist does not want to be responsible for the tip.  Our set says -PICC tip _______read by (radiologist name).  PICC OK for use by(physician authorizing use).

We call the attending or appropriate resident or intern to get permission to use the line after the radiologist reads the film.  We have a blank space for where the tip is  because even though we may not have made it to the ideal tip location for one reason or another, in pediatrics, sometimes you have to taske what youcan get, so we sometimes use lines that don't have ideal tip location depending on what the line is needed for.  Sometimes pulling it back and making it a midline is not an option -especially in a baby whose whole arm is less than 10cm long.      

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