During my visit to China I learned that the Nurses are skilled in PICC line insertion. Some nurses place over 500 PICC lines a year. This is amazing! I have been placing PICC lines for 18 years and I can’t even imagine placing that many in one year. Complications post insertion was the hot topic while I was there. The most common questions was “How do we identify thrombosis early” and “What to do if a Phlebitis occurs”. The first thing I said was we can prevent both complications from occurring. When talking with the skilled PICC nurse, we discussed choosing the right vein for the catheter size. When talking with the floor nurse, we discussed prevention and early detection of thrombosis and Phlebitis. In the USA we clear catheters with the thrombolytic, Activase, this has not been approved for use in China. The picture attached to this blog is of a patient that I was asked to see that had a upper extremity DVT post PICC line. We discussed elevating his arm, cool packs for swelling, acetaminophen for comfort. His PCP ordered oral Coumadin. He will need another device some time soon. The patient has cancer and will need chemotherapy. Unfortuntely with this complication, the patient will have a delay in his therapy. The Nursing staff was very concerned about how to prevent this from occurring in the future. We all want the best outcomes for our patients with minimal complications.
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