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MarkCVL
X-ray post PICC....What do you order?

When you finish your PICC placement at bedside and order your bedside x-ray to confirm placement.....What do you order?

PA CXR

PA CXR with Oblique...if Oblique, what degree?

Something else?

Does your radiology department do any tricks to enhance tip visualization?

lynncrni
If you order a PA chest, that

If you order a PA chest, that means that the patient will always have to go to the Rad dept. An AP is done if the patient is bedridden. PA provides better results because the anterior chest is closer to the film and catheter is in the foreground. I have not heard any discussion or recommendations about the need for an oblique film in many years. Lynn

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

MarkCVL
Thanks for the correction

Thanks for the correction Lynn....you are correct...Bedside we shot a AP not a PA

Carole Fuseck
Post Insertion X-ray

Hi Mark,

Our facility shoots a portable AP for placement.  If the patient is obese we leave the insertion wire in until the film is shot to assist with visualization of the tip. 

 

Juline
We order a portable "single

We order a portable "single view" chest x-ray. Our computer system gives us  "single view" as a choice- We then must enter the reason as for "PICC Tip Placement". Our X-ray techs do a slightly oblique positioning. The X-ray techs have been told by the radiologists whenever order is for PICC tip placement to automatically do slightly oblique. They tell us it is just slightly oblique. Sorry I don't know what degree that is. It also makes easier for the IV nurses to see the tips on the x-rays too. Although we don't do the readings of the X-ray alot of times we like to look at them, especially if it was a difficult placement. We have had a couple pts there were extremely obese that we left the wire in just until the x-ray was taken so that tip was easier to be read instead of getting a reading saying "unable to visualize tip". We have noticed that some radiologists have less difficulty reading tip placements then others.

If the patient goes down to x-ray- they do a PA and Lat for placement. Most of our x-rays are done at the bedsie.

Juline DiSilvestro BSN, RN, CRNI, VA-BC, CPUI
Central Access Team Nurse
Inspira Medical Center- Woodbury,NJ

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