Is anyone aware of articles/position papers on the use of PICCs for emergent access versus IJ CVLs? I think for the patient with no peripheral access that is "crashing" and in emergent need of fluid resuscitation, pressors etc., a CVL is faster than a PICC. Is there any research or official position on this issue? I have found that it takes longer to find and access a large enough upper arm vein under these circumstances and feel the patient's life is put in jeopardy by the delay in access. Thanks for any information on this.
I have always been taught that there is no such thing as an emegency PICC due to the time needed for insertion and the delay in tip confimation. It is impossible to place and use a PICC within 1-2 minutes thus precluding it as an access line in an emergency. There are certainly many urgent PICC's but placement for a true emergency would waste valuable time.
I think there is a difference between emergent and urgent. Emergent would be where infusion therapy is required within a matter of minutes and a PICC is not the answer for that sitaution. However, there are many patients in need of urgent infusion therapy and your VAD services should be able to accommodate those patient needs, in my opinion. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I think we need to be open minded. I tell everyone I can’t do emergent line placement because I am the only vascular access nurse in a 425 bed hospital and I don’t want it to be an expectation. I can’t because I could be in another procedure. With that said I HAVE done them emergent and urgent in many occasions and with meds being pushed in the PIV and stat EKG being done. Now that I am using VPS the line can be used immediately after placement. It’s very exciting when you are the person that can give the patient the access they need without delay. In many cases the vascular access nurse can get the right device placed faster with less complication than I physician. Make yourself valuable, we all should feel empowered by our skill set!