PICCs: how Doppler ultrasound can extend their use

Article Abstract:

Peripherally inserted central catheters (PICCs) enable the central delivery of drugs and infusates. The tip of the PICC extends to the superior vena cava, but health professionals must verify the position of the tip before administering the drug. This necessitates a visit to the radiology department for either X-rays or ultrasound and fluoroscopy. The use of hand-held Doppler ultrasound equipment can significantly reduce the number of patients who have to go to the radiology department, thus reducing costs, hastening treatment, and causing less stress for the patient.

Usage, Doppler ultrasonography

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Fibrin sheaths in vascular access devices

Article Abstract:

Nurses who site intravenous catheters must prevent the unnecessary withdrawal of vascular access devices by learning the management and diagnosis of frequently-occurring problems. Persistent withdrawal occlusion can result from an anatomical obstruction or the incorrect positioning of the catheter tip. The majority of catheters will develop a fibrin sheath if left in place for over one week, with the fibrin sheath becoming a one-way valve. The lumen must be patent prior to the administration of intravenous fluids or drugs in order to facilitate free passage.

Study and teaching, Nursing, Blood vessels, Catheters, Venous cutdown

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The successful use of a non-open-ended PICC line

Article Abstract:

A non-open-ended, peripherally inserted central catheter was used to facilitate venous access in a patient suffering from Hodgkin's lymphoma. Philippa Morgan was being treated with a 12-week course of out-patient cytotoxic chemotherapy when venous access became increasingly difficult. The PICC was inserted on week eight of the treatment, resulting in painless and problem-free chemotherapy injections for the remaining four weeks.

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