The Importance of the Need for Early Vascular Access identification

I'm so glad to see this subject addressed. My sister was in the hospital a few months ago and had to stay for eight days. During this time she had to have her IV changed at least once per day, as her veins blow easily and they were giving her IV ABX. I suggested a PICC, but the physician didn't want to order it as "she'll only be here a few days". So she wound up getting poked over and over again, and of course with terrible veins there were only a few places they could put an IV in the first place. Toward the end they had to put one in her foot. Ridiculous.

Very important article for parents of peds pts too. My youngest granddaughter who was 2 1/2 years ago had a hemorrhagic CVA in June due to an undiagnosed Chiari I malformation. She had emergency brain surgery, trach/peg, central line placement, PICC line and spent 2.5 months in the PICU. It was a nightmare. The peds nurses and APNs were fantastic. My granddaughter ended up with a DVT from the PICC line unfortunately and this is a common complication. However, it is still very important that vascular access for critically ill children be chosen with care.

Excellent article! As a fellow Peds RN I totally agree with this. Whenever we have a patient who is a difficult "stick" and they are expected to be receiving a long course of strong antibiotics, frequent labs, or other vein-related interventions, I start to bug the docs every time they round about considering a PICC. I know there are risks of infection, but our unit in particular has a stellar record at avoiding infections and I point this out, too. It is inhumane and traumatic in today's world of modern medicine to expose a child to multiple pokes, IVs going bad after just a few doses of a stronger med, and the risk of tissue damage from these vesicants. The previous poster brought up DVTs and this is a legitimate risk that reminds us that there is no perfect solution . . . but some solutions are better than others for certain situations.

Quote from traumaRUsVery important article for parents of peds pts too. My youngest granddaughter who was 2 1/2 years ago had a hemorrhagic CVA in June due to an undiagnosed Chiari I malformation. She had emergency brain surgery, trach/peg, central line placement, PICC line and spent 2.5 months in the PICU. It was a nightmare. The peds nurses and APNs were fantastic. My granddaughter ended up with a DVT from the PICC line unfortunately and this is a common complication. However, it is still very important that vascular access for critically ill children be chosen with care.

I really do wish we would line people right away. Some of our docs are good about this, others aren't. It really should happen for most people.

Thanks for the kind words. My granddaughter presented with altered LOC and agonal respiration - there was initial concern for partial airway obstruction so after two peripheral IVs were placed (on the first stick as she was a very healthy little girl), they took her emergently to the OR for a bronch and controlled intubation. She got two femoral lines placed within 12 hours of admission for which I was very grateful.