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PIV Vascular Access Cases

PIVs Vascular Access Cases highlight some of the interesting Nurse Clinicians in Action cases that Vascular Wellness clinicians have encountered and participated in treatment.  Peripheral IVs and Extended Dwell PIVs, which are ultrasound guided, are the most common and least intrusive standard lines used for establishing vascular access. Our hospital-credentialed, board-certified clinicians provide hospital-quality PIVs at the patient’s bedside, no matter where that is, for clinically appropriate therapies.

UNDETECTED DVT IN SKILLED NURSING PATIENT | NCIA-37

PIV Vascular Access Cases: This case took place in a Skilled Nursing Facility (SNF) where an elderly patient needed a PICC line.  The PICC line he received while in the hospital had been removed accidentally prior to his discharge back to the SNF, so he needed a replacement to complete a course of antibiotics and fluids for a few more days.  The Vascular Wellness nurse clinician arrived a short time later and began reviewing the order and medical history.  The patient explained that his right arm where the previous PICC had been was extremely sore and red and begged her to not touch it. The clinician saw this when she arrived and assured him she was not performing a procedure in that arm.  Based on her extensive experience, however, the clinician believed she saw a possible DVT in the right upper extremity. She recommended a Doppler ultrasound to rule it out, and offered to place a PIV in the meantime, as it was not contraindicated. The care team agreed, she placed the PIV, and a short while later it was confirmed that the patient had a DVT.  The facility and staff were extremely thankful for the expertise the Vascular Wellness clinician provided.

HOSPITAL AT HOME DIFFICULT STICKS | NCIA-35

PIV Vascular Access Cases: A patient who presented to the Emergency Department at a hospital and received initial treatment was confirmed to be a good candidate for their Hospital at Home program, and the patient was able to return home to continue her treatment plan. After several days of in-home treatment, labs were ordered to confirm the patient’s healing progress. The medical provider arrived at the patient’s home and made multiple attempts to gain vascular access but was unsuccessful. Unfortunately, the patient’s veins were depleted, so she had endured more than 10 unsuccessful attempts, which resulted in numerous and unnecessary painful needle sticks. Vascular Wellness was consulted to assist, and the clinician arrived at the patient’s home and checked in onsite via the remote virtual terminal. After assessing the patient’s vasculature, the clinician then quickly and effortlessly achieved vascular access on the first attempt utilizing ultrasound guidance. The patient was thrilled and stated, “I didn’t even feel it, I was expecting to be poked a lot more that that!”

FRACTURE AND EXTRAVASATION COMPLICATES VASCULAR ACCESS | NCIA-25

PIV Vascular Access Cases: A hospital patient who suffered a fall that resulted in a fracture and surgical intervention had a PIV in place that was being used to administer Vancomycin, a powerful antibiotic, but needed additional vascular access for a blood transfusion. The facility tried many times to establish additional vascular access but were unsuccessful and contacted Vascular Wellness to assist. Upon arrival, the clinician immediately noticed the areas from failed attempts, as well as an area of irritation, redness, and darkened skin in addition to fluid-filled blisters in the area and immediately suspected a Vancomycin extravasation. The facility believed the blisters were from a reaction to tape adhesive, but the patient denied ever having a problem with the tape, and there was no tape in this area of concern. The clinician recommended a wound nurse consult to confirm and care for the extravasation, and then quickly and safely placed a new PIV. The staff nurses were thankful for the opportunity to observe a specialized vascular access procedure, and more importantly, they were appreciative that this complex vascular access problem was identified and resolved.

PICC DOWNGRADED TO PIVS AFTER VA-BC NURSE ASSESSMENT | NCIA-51

PIV Vascular Access Cases: A PICC line was placed and then subsequently removed at the completion of therapy in patient in an outlying community hospital. Three days later, the care team contacted Vascular Wellness and ordered another PICC line for new antibiotics as well as an upcoming cholecystectomy. Upon reviewing the chart, the Vascular Wellness clinician noted that the patient had two PICC lines in the previous 15 days, and this order would make it a third PICC line in a very short timeframe. The clinician explained that over accessing vessels via a PICC line or Midline can put patients at an increased risk of catheter associated infections and DVTs (deep vein thrombosis) and recommended placing two peripheral IVs (PIVs) instead of a PICC line to eliminate these risks. She also confirmed that the PIVs were a clinically appropriate vascular access solution based on the prescribed medicines and care plan for the patient. The care team was very grateful for the clinician’s expertise and guidance, and for providing the patient with the safest, least invasive, and most appropriate vascular access in the same visit. 

PIV Vascular Access Cases: Key Points

Key points for vascular access cases
Our clinicians are VA-BC certified, skill tested, and skill verified semi-annually and can rely on the breadth of their intensive training to achieve successful access, including in complex cases and difficult intravenous access (DIVA) patients.
Key points for vascular access cases

Our clinician’s expertise often gets utilized successfully after failed attempts by other clinicians. We have a 98+% success rate with 0% insertion-related infection rate across all lines.

Key points for vascular access cases

As Vascular Access Experts, our clinicians are not only trained and precepted in placing Ultrasound Guided PIVs, Midlines, PICCs, and Small and Large bore lines but also in identifying contraindications and comorbidities during physical examinations and medical history reviews.

Key points

Having a clinician who is able to pivot when a prescribed line can be downgraded or advanced means that your patient can receive prompt care in place, reducing patient complications, avoiding transportation costs, and allowing your medical team to focus on their field of practice.

Key points

Our large footprint of specialists are available 7 days a week, including after-hours, holidays, and weekends, have a 3-hour average response time, and 95% of our calls are serviced the same day and within 6 hours.

Learn more about all
Vascular Access Services

Learn more about PIV
Vascular Access Services

As Vascular Access Experts, Vascular Wellness is the largest provider in the southeast of comprehensive vascular access services, including standard and advanced line placement, pediatrics, program management, education, training, and infection control and prevention to all healthcare settings such as Tertiary Hospitals, Community Hospitals, Long-Term Acute Care Hospitals, Skilled Nursing Facilities, Hospice, and At-Home. We support a 98+% Success Rate with 0% insertion-related infection rate across all lines, with an average response time of 3 hours. We help our clients improve patient outcomes, enable faster therapy, reduce costs, infections, and readmissions, decrease hospital length of stay, and eliminate transportation.

NURSE CLINICIANS IN ACTION case summaries involve challenging situations or intriguing clinical presentations where Vascular Wellness was able to create clinically appropriate access promptly, minimize sticks, and place the right line at the right time, the first time.

Find More NURSE CLINICIANS IN ACTION Case Summaries by clicking below

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