Vascular Access for Quadriplegic Patient describes how a Vascular Access clinician was able to rely on his knowledge, training, and experience to expertly assess a quadriplegic patient in a skilled nursing facility to recommend and gain physician approval for a safer alternative solution to the ordered line.
Vascular Access for Quadriplegic Patient
– Clinical Case
This case occurred in a Skilled Nursing Facility (SNF) with a quadriplegic patient needing long-term antibiotics due to a urinary tract infection. Vascular Wellness was initially consulted to place a PICC line for six weeks of therapy. Upon arrival, the Vascular Wellness clinician discovered the patient had a wound with a dressing on one arm, so the other arm was assessed with ultrasound for access. Unfortunately, a non-compressible vein was found, and the vascular access clinician knew this was an indication of compromised vascular function. In combination with the patient’s paralysis, the vascular access clinician also realized that the ordered PICC was contraindicated. Not only would it not be an optimal solution for this patient, but the insertion of a PICC could also present a higher risk of venous thrombosis.
Vascular Access for Quadriplegic Patient
– Diagnosis and Treatment
After a thorough ultrasound assessment of the patient’s upper extremities, the vascular access specialist confirmed a PICC could cause severe problems for this quadriplegic patient, who already had compromised venous circulation. Our clinicians work closely with our patient’s medical team, so the clinician contacted the physician immediately to relay the clinical findings and to recommend a viable alternative, the placement of a small bore axillary central line. This device would be a safer option for the patient because it is placed in a much larger vessel out of the upper extremities. The device would allow for a much greater catheter-to-vein ratio and significantly reduce the patient’s chance of developing catheter-related deep vein thrombosis. The physician expressed gratitude to our clinician for skillfully assessing the patient’s vasculature, considering all the parameters, and providing an expert solution. The recommended device was ordered, and the axillary line was placed without incident.
Vascular Access Experts
– Key Points
This case demonstrates how Vascular Wellness clinicians provide vascular access expertise in various settings and across a myriad of patient conditions. In this case, an expert assessment revealed co-morbidities in a paralyzed patient that required a new order for a different, more clinically appropriate, vascular access device. While many Vascular Wellness consult requests appear straightforward, our vascular access clinicians independently verify every patient’s medical history and current condition to confirm the correct device has been ordered. In this instance, a discussion with the physician and a new recommendation was required.
As Vascular Access Experts, we pride ourselves on having earned the trust of many Licensed Independent Practitioners who consistently order Vascular Access Consultations, not just device placement. Our partners (Medical Doctors, Physician Assistants, and Nurse Practitioners) who call Vascular Wellness for consults know that we always conduct thorough patient assessments and can also place the clinically appropriate line while our clinician is on-site – even a Small Bore Axillary Line which is generally unmatched by other PICC providers as they don’t have similar expertise. Quicker vascular access results in faster patient therapy.
Furthermore, our Vascular Access Experts can place both large and small bore lines in the clinically appropriate location, whether the arm, neck, chest or lower extremity. This skillful specialization distinguishes us from other vascular access contractor teams and PICC providers. Our employee model (W2 Employees), compared to an independent contractor model (1099 Contractors), allows for a more holistic, patient-centered approach to vascular access, beneficial to our clients and patients across the board. Our team of Vascular Access Experts is responsive, professionally trained, and highly skilled, and when we assess patients, make recommendations, and place clinically appropriate lines, our patients have fewer complications and more favorable outcomes.
Nurse Clinicians in Action is a spotlight series highlighting some of the interesting cases that Vascular Wellness clinicians have encountered and participated in treatment. These cases involve challenging situations or intriguing clinical presentations and may involve more than one Vascular Wellness clinician, as our clinicians have the ability to consult each other while in the field, as well as an on-call Clinical Administrator via a HIPAA (Health Insurance Portability and Accountability) compliant communication app. In addition, our extensive training program and diverse client base, including Level 1 Trauma Centers, Short Term Acute Care Hospitals, Long Term Acute Care Hospitals, and Skilled Nursing Facilities, provide our clinicians with a wide array of clinical experience and why we believe our clinicians, as a group, are the most experienced and best trained and supported vascular access clinicians.
If you require Vascular Access or want to learn more, speak to the team at Vascular Wellness today. For the latest articles and insights, follow us on LinkedIn, Facebook, Twitter, YouTube, and Instagram.
Vascular Wellness provides:
(1) Comprehensive vascular access services to North Carolina, South Carolina, and Virginia;
(2) Customized vascular access services to Tennessee, Georgia, and West Virginia; and
(3) Support vascular access services to Pennsylvania, Ohio, and Kentucky.
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