Herbs

Hi All, Here at King Faisal Hospital NICU in Riyadh, KSA, we have been inserting PICC's since 1992. It was a nurse driven project. We have used several resources for our PICC guideline. One of them is the book guide from PICC Excellence. Currently we updated our guideline. This time we follow the guideline from NANN. For those of you who wants to have PICC guideline in your unit, I recommend this book from Advances in Neonatal Care - the official journal of the National Association of Neonatal Nurses (NANN). The book's title " Peripherally Inserted Central Catheters, Guideline for Practice, 2nd edition by Janet Pettit et al." The book has everything from insertion procedure, to dressing and troubleshooting. You can google their website and check their contact address to purchase the book. Good luck. Herbs Ibrahim HIbrahim@kfshrc.edu.sa

It seems the procedure you mentioned is good for the ELBW. We are using BARD Fr#2 PICC. The introducer is so huge for a 500 gr preemie. PICC thru a peripheral cannula will be a better idea. Thanks for the reply Stefan. Herbs

How do you insert PICC via peripheral cannula? Do you use angio catheter g#24?Can you thread the catheter in? Or do you use guidewire? If with guidewire, what size of guidewire? I am interested to know. Please email me. Thanks. Herbs HIbrahim@kfshrc.edu.sa

Hi Everyone, It has been the recommendation in the past and up to now to apply warm compress on the reddish area for PICC with phlebitis for 24-48 hrs. My question how do you apply the warm compress? What we do in our unit, we pour warm water into a clean glove. We will test the temperature of the water in the glove on the sensitive skin part of the arm.We then make a knot at the end of the glove then wrap the glove with clean thin wipe before applying on the reddish part of the PICC. We change the water and glove with every care. We will assess with every care and we will make our final assessment after 24 hours whether the phlebitis subsided or disappeared or worsened. If it becomes worst, then we have to removed. I am looking for the latest evidence how should the warm compress be applied for PICC with phlebitis. Please if anyone who has the latest information regarding this, email me. Thanks. Herbs Ibrahim HIbrahim@kfshrc.edu.sa

Hi Jean, I just want to know if you use IV contrast routinely when doing x-ray for PICC line tip placement? Do you have cases of deceiving x-ray showing proper PICC placement but then when you use IV contrast, the PICC line tip is too far deep in the heart. Thanks, Herbs HIbrahim@kfshrc.edu.sa

Hello, With our PICC lines we always run it with infusions. But since we started using the double lumen PICC, we encountered moderate numbers of blocked lumen esp. the lumen that is unused and kept KVO (1cc/hr). We use BARD products. Did you encounter such problem? What do you do to prevent it from blocking? Herbs email: HIbrahim@kfshrc.edu.sa