Michael Anstett who is an independent PICC contractor in Florida did a wonderful presentation at AVA in a break-out session.Â He followed 100 PICC lines placed in skilled care patients for thrombosis after power injections for four weeks with doppler at week 2 and week 4.Â He found a zero percent thrombosis rate in 100 patients with a Medcomp reverse taper PICC line
He did not do pre-scans which would have been nice to say the vessels were clean prior to the insertions as well.Â The vessels on doppler were clean post-scan.Â He is publishing his results in the AVA journal.Â
There is a tape to buy and his slides are on the AVA website if I am not mistaken from the program he gave.
We need more RN's publishing as Anstett's presentation is still considered anecdotal without a paper behind it.Â Unlike any papers published on thrombosis the catheters he placed were not midclavicular, with no x-ray, and were placed with ultrasound and micro's.Â The majority of papers with RN results are so old that they have no new technology or PICC tips placed in the lower one third of the SVC and are therefore irrelevant.Â The Grove study that seems to be the pinnacle study for someÂ even shows that RN's have a higher thrombosis rate for the 5 French Â PICC line as a result of using old technology.Â The RN thrombosis rate on the 5 French was >10% versus doctors a little over 5%.
It would be nice to have studies where the date was collected in the decade of 2000 and not in the 1990's.Â Even the famous Maki chest article on PICC lines have a high infection rate has data in it collected from the 1990's but not published until 2005.
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