What experiences are iv teams having using the sapien system? Would like a range of feedback from different IV Teams regarding how effective it is - pros and cons. thanks
My problem with sapien is that it always leave at lease 2cm external length of the catheter out. It makes the dressing change more difficult for the staff nurse. The catheter would come out more over time with each dressing change and the site tend to bleed if the catheter has a longer length out. I just feel that there is space to improve. I like all the line eventrally to be placed like a IR PICC placement with all tip in the CA junction and 0 external length.
Totally agree with you, Emily. That is what I'm hoping for as well. I've not tried any ECG tip location systems yet, but I've heard from others that you have to leave some external length out. I don't like that either.
Ann Armstrong, RN
MidMichigan Medical Center, Midland
Our PICC team has been using the Bard Sapiens system for close to a year now and the system has been very accurate with placement in the CA Junction. As far as the measurements and external length I can not complain. The most external length we really have is 2 cm, which is easy to work with. How much external length is all dependent on how confident the inserting RN is with their own measurements because in order to get the max p wave the Picc obviously needs to be long enough to reach the CA Junction. Has been a real time saver not having to get a chest xray.
"The most external length we really have is 2 cm". I think the least external is 2cm since you have to pull back 2cm when there is the change on the P wave thus 2cm minimum.
"Has been a real time saver not having to get a chest xray. " Procedurewide, it doesn't save any time but consumes more for the setting up. If you had a lot of malpositions before, sapien might help. But generally speaking, it takes more time and always has to leave external catheter.
How does it work with patients that have pacers or A-fib? Almost 1/4 of our patients are this kind of patients. And also, is the sapien the same accurate on both side of the arm?
What you are describing sounds more like the Bard 3 CG. With Sapiens you do not have to pull back 2 cm once you get max P. You reach max p and leave it. The extra 5-7 minutes of setup beats waiting the 30+ minutes for the chest xray result. Patient's with pacers and Fib are not candidates for Sapiens.
How do you know you have reached the max P? You have to reach it and keep going until it drops. You pull back from there. So you still have to pass that point and pull back some of the catheter no matter if it is 2cm or not to get back to the max P.
As I have mentioned before and like a lot of other PICC nurses, we don't like that external length at all! As of now, without using sapien, our first time distal-CA junction rate is over 87% without external length. I think we can wait for something better to come up.