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IV procedure now available at St. Luke Hospital

Staff reporter

It takes skill, practice, and sometimes nerves of steel to be able to insert a PICC line.

A peripherally inserted central catheter is inserted by trained medical personnel in those patients who need venous access for fluids and medications.

And now, that expertise is available at St. Luke Hospital, Marion.

Registered nurse Brenda Larson became certified in March 2006, while she was an employee at Susan B. Allen Hospital, El Dorado. Since July, she has been a full-time nurse at St. Luke Hospital.

"It is a minimal invasive procedure done on an outpatient basis," Larson said.

Previously only available at larger, area hospitals like Memorial Hospital in McPherson and Newton Medical Center, patients now can have the procedure done locally.

Patients who are candidates for the procedure are those who need long-term nutritional support through IV therapy or take multiple antibiotics that are corrosive to the veins.

The catheter is placed through a main artery in an arm and is connected directly to the heart. Fluids and medications then bypass all of the other veins and go directly to the heart.

The service also is available through Marion County Home Health Care.

"The catheter can remain in place until it is no longer needed or continues to be accessible," Larson explained. The line can be removed and reentered if necessary.

Maintenance of the catheter sight is necessary and that, too, can be completed at the Marion hospital.

For now, one nurse is sufficient to meet the demand for the procedure.

Larson said the procedure isn't for every nurse to do.

"I performed dialysis on patients for six years before becoming an RN," Larson said, "and I've seen a variety of conditions and accesses for IVs."

With her background, it seemed natural to Larson to become certified to insert PICC lines.

To be certified, the professional must be an RN, receive the required training, and prove proficiency skills which includes placement of the line.

"I attended a one-day course but had to perform three supervised placements before I was certified," she said.

PICC insertion is a scheduled event, Larson said, not on an emergency basis.

To maintain certification, Larson will need to be observed by another PICC line nurse at least once a year — another reason for a second nurse at St. Luke Hospital to become certified.

The procedure

The modified Soldinger technique is used by Larson.

"The hardest part (of the procedure) is getting the IV site established," she said.

The IV is inserted two inches below or above the elbow. There are two veins in the arm that can be used. The catheter rests in the tip of the heart which allows fluids and medications to pump directly to the heart, bypassing smaller veins that can be damaged.

Placement of the catheter is confirmed by an X-ray and a medical doctor before any fluids or medications are allowed.

The entry also can be used to draw blood and for blood transfusions.

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