double lumen picc line tpn and antibiotics

Double lumen picc line tpn and antibiotics full#

The catheter can remain in situ for the length of the patient’s treatment.

It is cost effective in both time and monetary terms, as hospital costs are reduced when children are being treated at home.

There is a lower risk of catheter related infections 1.

It allows for home therapy in children with chronic illness and allows them to continue their normal routine at home including school, games and hobbies.

It allows the child prolonged central access resulting in consistent delivery of TPN and hyperosmolar solutions (dextrose of 15% or greater).

PICC lines allow for less anxiety and discomfort to the child, caused by repeated attempts at peripheral cannulation.

PICC placement is less traumatic than central line placement and is no more uncomfortable than a peripheral cannula 4.

3 As these devices are inserted at ward level without surgical intervention it is a favourable route for central access particularly for children with chronic illness, eg. 2 The correct placement of a PICC ensures longevity and decreases the risks of infusion related complications such as phlebitis and thrombosis. The location of the tip should be in the lower third of the superior vena cava as this vessel is large and can tolerate large infusions as it has a high volume of blood flow. The procedure must be done under strict aseptic technique to ensure sterility of the line entering the venous system.Īn x-ray must be taken to ensure it is in the correct position. The PICC position must then be secured with sterile steri-strips to prevent dislodgement and catheter migration. Insertion is achieved by cannulating a peripheral vein with a needle, passing a thin walled polyurethane catheter through, and advancing it forward to the superior vena cava, then the cannula is removed. Measurement of the site is imperative prior to starting the procedure to ensure that the catheter is positioned correctly and does not enter the atrium of the heart, which can lead to cardiac arrhythmias.

Ensure patients/parents understanding of procedureĪn assessment of the sites available to insert the IV is also considered, the most common sites include the basilic, cephalic and median cubital veins in the arm.

Measure level of co-operation anticipated.

Verify patient’s clinical status including baseline temperature, pulse rate, respiratory rate, white cell count and coagulation status.

Establish duration of and type of therapy.

Ascertain suitability for PICC placement.

Establish the need for the PICC and if it is acceptable to the child and family.

Double lumen picc line tpn and antibiotics full#

1 Prior to inserting a PICC, a full assessment must be made of the child to ensure a PICC is the appropriate method of intravenous access (see Table 1). PICCs are a group of single and double lumen central venous access devices, the tips of which terminate centrally in the superior vena cava. PICCs have been in use since the 1970s in the US and since the 1980s in the UK. The availability of the service has resulted in a reduction in hospitalisation for patients and an increase in patient/carer satisfaction. A nurse-led PICC (peripheral inserted central catheters) placement service was established to develop this area of expertise. The need for more intermediate and long-term intravenous management was identified. The Intravenous nursing team (IV team) at the Children’s University Hospital, Temple Street is dedicated to providing best practice in the specialty of paediatric cannulation.

Children's Hospital is proving successful for patients, writes Fran Johonston and Brid Kennedy.

The nurse-led PICC placement service developed at Temple St.