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raynaud syndrome

Hi, Just a short comment to thank all the members for the great information.  This site is invaluable.  Recently I was unable to place a Picc with ultrasound on a woman with severe Raynaud.  I purchased the vein x3 with great blood flow but the guidewire would not go more than 10 cm. I questioned wether the woman should have a Picc placed  but the MD insisted.

 

Thank you inadvance

Andrea

Halle Utter
I have had times where the
I have had times where the wire won't advance as far as I might like, but sometimes I think it gets caught behind a valve in the vein. There are times when this has occurred that I have gone ahead and placed the introducer anyway and the softer larger catheter advances just fine, especially with a little flushing along the way. If my options are limited I might be more inclined to try this technique.  With Raynauds disease you could also be dealing with spasming, and flushing might have done the trick to help the vessel relax.  

Hallene E Utter, RN, BSN Intravenous Care, INC

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Thank you for your
Thank you for your response.  I will definately keep this in mind in the future. 

dsnyrn

Terry Hall
I frequently will use a
I frequently will use a smaller size guidewire when this occurs. I usually have a 3Fr or 4Fr conversion kit on the PICC cart for this purpose. Lubricating the guidewire, no matter what the size, with NS will also promote the successful advancement of the wire. 
Robbin George
I like the idea but cannnot
I like the idea but cannnot conceptualize how you "LUBRICATE" the guidewire with NS--Please describe the process--Thanks 

Robbin George RN VA-BC

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