Totally freaking genius!

On the last day of my rotation, i became the first person in the history of the Children's respiratory department to insert a PICC on the wards, without assistance. I think i absolutely deserve bragging rights.

The story has its beginnings in the prolonged hospital stay for CF tune ups. In an adult hospital, a 2 week tune up means 5 IV resites, which is unacceptable for children in general, not to mention those with chronic diseases needing frequent admissions.

Hence, the long lines which if properly cared for lasts for weeks. The advantage of a long line being that it can be done on the wards, no fussing and begging for theatre time, and only a short 2 hour period of fasting required if sedation was necessary.

As for the cons, the list goes on and on, starting from it's procedural difficulty. This 2 French finicky line is so soft that when met with any minute resistance from the vein, even extravasation of blood, it will not thread.

Once successfully inserted, the problems do not end.

There are only a handful of people in hospital that know how to insert one, and many ignorant nursing staff who either don't lock it with heparin (hence allowing it to be clotted with blood), put too much pressure while flushing it (hence bursting the line), or mistakenly think that it's not working hence removing it altogether (which drives me utterly insane each time it happens).

The idiocy of it all resulting in increasingly difficult veins, multiple stabs for the patients, and if unsuccessful at reinsertion, a general anaesthetic for a PICC insertion, wasting of precious theatre time and unwelcomed solicitation of the ire of all anaesthetists.

Due to all these problems, a clinical survey was made, cases collected, and a push for change commenced. That was when we found out that most of the consultants have never laid eyes on one let alone the "pleasure" of inserting a long line.

The audacity! It was absolutely preposterous to ask us to employ long lines when they are not aware of what it even looks like.

Which brings us to the PICC.

I've assisted once in the insertion of a PICC more than a year ago in SCH and since then have not remotely glimpsed or touched the packaging of a PICC.

After opening said packet, playing with the equipment and trying to match it with the instructions that didn't make sense (even to my reg), i finally got it figured out by pure intuition.

Hands trembling with the adrenaline rush, the brain whirred with impromptu solutions to the obstacles of inserting the introducer and attaching the connector bits, while explaining the step by step process to my patient and trying to sound like i've done it a million times before.

Finally, the PICC was in the vein, connected up, taped down with absolutely all sticky things i can find and patient in no pain whatsoever throughout the procedure.

Hallelujah!

*Queue applause*

Thank you! Thank you! *Waves hand in air Miss Congeniality style*

MOAO and my other friend will tell you how i described to them in detail the process, bored them shitless and amazed them with the thickness of my skin and copious flow of saliva.