Monday, March 1, 2010
We don't like the new PICC afterall
There, it's official. We do not like the new PICC that Peter got in January. I do like a PICC line in general, but not this new one. The biggest frustration with it is the placement. This may be a very boring entry for anyone who does not have a PICC line, but for someone familiar with PICCs, perhaps it will be of interest. I do need to vent this frustration, so I am posting it.
For the last three years, Peter's PICC lines were secured with a little adhesive device called a Stat-Lock, which was located about an inch below the actual insetion site of the PICC line. It was a good set-up, as the Stat-Lock was capable of lasting up to a month and did not need to be kept sterile since it was so far away from the insertion site of the PICC.
The new line has the Stat-Lock actually just one or two millimeters from the insertion site, surrounding the site itself, and now needs to be changed every week with the dressing change. The Stat-Lock device has these little "doors" that keep the PICC line from popping back off the device, and these tiny movable posts on which the PICC cross post need to be landed. Somehow this is all to be kept sterile as we are opening and closing the little doors to remove the old Stat-Lock, and then opening and closing little doors as we put on the new Stat-Lock. It can be done on a mannekin arm or on an adult that stays still, but on a four-year-old child, it gets a little tricky, even with another adult immobilizing the arm and Peter's body. To remove the old Stat-Lock, we need to lift up the PICC line, which then tries to work its way out of Peter's arm while we frantically work on keeping it from sliding out, sterile gloves becoming dangerously close to non-sterile, if not truly non-sterile despite our best efforts. It is like trying to manipulate a wet noodle as it wants to slide out and we are trying to push on it to stay in. Once the entire site is cleaned, we can put the PICC line down and hold it more securely, but then we have to lift the PICC line again to place the new Stat-Lock on... trying to be sterile, landing it just a millimeter or two away from the sterile insertion site, wet noodle thing happening again.
The whole procedure is ridiculous in light of the set-up we used to have. We have had so many people remark on how well we maintained his old site and how remarkable it was that he didn't get PICC line infections. With this new line sliding in and out during dressing changes and with the Stat-Lock so close to the insertion site, I will be the one amazed if we are able to keep Peter's line infection free, or from just sliding on out during one of our dressing changes. We are hearing from some of Peter's nurses that this is the current procedure for PICC lines, with the Stat-Lock where our new one is. I will not be surprised to see that the rate of infection also rises with this current trend.
For the last three years, Peter's PICC lines were secured with a little adhesive device called a Stat-Lock, which was located about an inch below the actual insetion site of the PICC line. It was a good set-up, as the Stat-Lock was capable of lasting up to a month and did not need to be kept sterile since it was so far away from the insertion site of the PICC.
The new line has the Stat-Lock actually just one or two millimeters from the insertion site, surrounding the site itself, and now needs to be changed every week with the dressing change. The Stat-Lock device has these little "doors" that keep the PICC line from popping back off the device, and these tiny movable posts on which the PICC cross post need to be landed. Somehow this is all to be kept sterile as we are opening and closing the little doors to remove the old Stat-Lock, and then opening and closing little doors as we put on the new Stat-Lock. It can be done on a mannekin arm or on an adult that stays still, but on a four-year-old child, it gets a little tricky, even with another adult immobilizing the arm and Peter's body. To remove the old Stat-Lock, we need to lift up the PICC line, which then tries to work its way out of Peter's arm while we frantically work on keeping it from sliding out, sterile gloves becoming dangerously close to non-sterile, if not truly non-sterile despite our best efforts. It is like trying to manipulate a wet noodle as it wants to slide out and we are trying to push on it to stay in. Once the entire site is cleaned, we can put the PICC line down and hold it more securely, but then we have to lift the PICC line again to place the new Stat-Lock on... trying to be sterile, landing it just a millimeter or two away from the sterile insertion site, wet noodle thing happening again.
The whole procedure is ridiculous in light of the set-up we used to have. We have had so many people remark on how well we maintained his old site and how remarkable it was that he didn't get PICC line infections. With this new line sliding in and out during dressing changes and with the Stat-Lock so close to the insertion site, I will be the one amazed if we are able to keep Peter's line infection free, or from just sliding on out during one of our dressing changes. We are hearing from some of Peter's nurses that this is the current procedure for PICC lines, with the Stat-Lock where our new one is. I will not be surprised to see that the rate of infection also rises with this current trend.
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