Hi
I am looking for information about the need to do an ultrasound in patients who have had previous central lines. Does anyone know where I could find articles that support or dispute the need? Our medical director who is a pediatric surgeon and who places tunneled catheters/ports wants us to add this to our request form. I was wondering if this is something that is only a pediatric thing or something that I have just not heard of before.
Thanks!
If I had to take a guess I would say he is trying to establish if there is central stenosis prior to bedside attempt. If he finds it does he then take the case to OR? Sounds like a waste of money and resources in the adult population, in the pediatric population unsuccessful nurse insertions would probably best be served in IR. Perhaps I am too cynical!!! Normally the person going in a new direction should provide the articles and information supporting why they want to do something...did you try putting the ball in his court?
Stephen Harris RN, CRNI, VA-BC
Chief Clinical Officer
Carolina Vascular Wellness
We often place PICCs on patients that have had previous tunneled catheters or ports, sometimes several. I am not aware of any article that recommends doing ultrasounds routinely (or not). If we have difficulty advancing a PICC (on a patient with previous surgically placed cvls) we may request an ultrasound to determine if the patient is a candidate for a PICC or will need other options. Some of our patients have had multiple lines and our surgeons will order an ultrasound to assist in decisions regarding future lines. Ultrasound is determined on a patient by patient basis. These are all pediatric patients.