sedation for a PICC line

mag6125

New member
I hate hearing how all your kids have to go through this everytime they have ivs. It just blows my mind because when I was young I just had a normal iv, even when I did meds at home, I never had my first PICC until I was about 12. I know the meds we use are hard on the veins and normal lines don't always last very long but I was just curious what kind of reasoning the docs give now for going straight to a PICC? Do they even give the option of a normal line anymore? I guess basically this all just makes me feel old. lol The only advice I can offer is it gets easier the older they get, I always had mine done with a local anesthesia and they use ultrasound to place it,of course by that age I'd had enough ivs that I prefered having a PICC placed to having a normal line. At the same time I've never had one put in at Children's because they didn't even do them there when I was younger, I've always gone to Akron General and they have amazing PICC nurses who still recognize me and my parents!
 

martysmom

New member
Oh my gosh Heather I am so sorry!!! That is insane and yes....BS!! When Marty had the PICC placed, they put him out. It was like it never happened for him. With that said, the hospital that our CF center is with STINKS!!! They did a great job with the PICC but their policy is that they don't like to do it on little ones because it is too invasive. So those SOB's (please pardon my french....I am very sensitive on this subject) left a peripheral IV in my kid for a week and had Tobramycin running through it. Every day I told them I wanted it out and have a PICC placed so that we could come home. Everyday there was no one to do it. Marty would shake when the meds ran through and one of the nurses told me "stop asking him if it hurts MOM, you are giving him ideas". I don't need to say much but I went balistic on her!!! Finally on day 7 I insisted they remove the IV because Marty had enough. I thought we were to go right down to have the PICC put in but then the resident comes in and tells me there is no one to do it......AHHHHH!! So they put in another Peripheral IV. At this point i had it and cried like a baby in front of all the doctors and nurses. Then that night the doc comes in and says he wants Marty to stay on the antibiotics longer. I said not unless we can do it at home!!! So on the 9th day he got his PICC and on the 10th day we went home.
One of the most difficult things that I am finding with all of this is how hard it is to advocate for my child. The doctors or nurses all looked at me cross eyed when I wanted to put a PICC in my kid. So the whole time I was afraid I was doing the wrong thing and something horrible would happen to him. Now in his chart it says what I want done and it is not to be done any other way until he can advocate for himself. He is to be put to sleep and get a PICC line put in right away and if he is well enough we are to go home.
I am so sorry you went through this. Medical personel are becoming so desensitized and they should really be advocating for their patients. A 4 year old should never have to feel that kind of pain. I do hope she is doing well now and you are enjoying being home. I am keeping you in my thoughts and prayers!!!
 

martysmom

New member
Oh my gosh Heather I am so sorry!!! That is insane and yes....BS!! When Marty had the PICC placed, they put him out. It was like it never happened for him. With that said, the hospital that our CF center is with STINKS!!! They did a great job with the PICC but their policy is that they don't like to do it on little ones because it is too invasive. So those SOB's (please pardon my french....I am very sensitive on this subject) left a peripheral IV in my kid for a week and had Tobramycin running through it. Every day I told them I wanted it out and have a PICC placed so that we could come home. Everyday there was no one to do it. Marty would shake when the meds ran through and one of the nurses told me "stop asking him if it hurts MOM, you are giving him ideas". I don't need to say much but I went balistic on her!!! Finally on day 7 I insisted they remove the IV because Marty had enough. I thought we were to go right down to have the PICC put in but then the resident comes in and tells me there is no one to do it......AHHHHH!! So they put in another Peripheral IV. At this point i had it and cried like a baby in front of all the doctors and nurses. Then that night the doc comes in and says he wants Marty to stay on the antibiotics longer. I said not unless we can do it at home!!! So on the 9th day he got his PICC and on the 10th day we went home.
One of the most difficult things that I am finding with all of this is how hard it is to advocate for my child. The doctors or nurses all looked at me cross eyed when I wanted to put a PICC in my kid. So the whole time I was afraid I was doing the wrong thing and something horrible would happen to him. Now in his chart it says what I want done and it is not to be done any other way until he can advocate for himself. He is to be put to sleep and get a PICC line put in right away and if he is well enough we are to go home.
I am so sorry you went through this. Medical personel are becoming so desensitized and they should really be advocating for their patients. A 4 year old should never have to feel that kind of pain. I do hope she is doing well now and you are enjoying being home. I am keeping you in my thoughts and prayers!!!
 

martysmom

New member
Oh my gosh Heather I am so sorry!!! That is insane and yes....BS!! When Marty had the PICC placed, they put him out. It was like it never happened for him. With that said, the hospital that our CF center is with STINKS!!! They did a great job with the PICC but their policy is that they don't like to do it on little ones because it is too invasive. So those SOB's (please pardon my french....I am very sensitive on this subject) left a peripheral IV in my kid for a week and had Tobramycin running through it. Every day I told them I wanted it out and have a PICC placed so that we could come home. Everyday there was no one to do it. Marty would shake when the meds ran through and one of the nurses told me "stop asking him if it hurts MOM, you are giving him ideas". I don't need to say much but I went balistic on her!!! Finally on day 7 I insisted they remove the IV because Marty had enough. I thought we were to go right down to have the PICC put in but then the resident comes in and tells me there is no one to do it......AHHHHH!! So they put in another Peripheral IV. At this point i had it and cried like a baby in front of all the doctors and nurses. Then that night the doc comes in and says he wants Marty to stay on the antibiotics longer. I said not unless we can do it at home!!! So on the 9th day he got his PICC and on the 10th day we went home.
<br />One of the most difficult things that I am finding with all of this is how hard it is to advocate for my child. The doctors or nurses all looked at me cross eyed when I wanted to put a PICC in my kid. So the whole time I was afraid I was doing the wrong thing and something horrible would happen to him. Now in his chart it says what I want done and it is not to be done any other way until he can advocate for himself. He is to be put to sleep and get a PICC line put in right away and if he is well enough we are to go home.
<br />I am so sorry you went through this. Medical personel are becoming so desensitized and they should really be advocating for their patients. A 4 year old should never have to feel that kind of pain. I do hope she is doing well now and you are enjoying being home. I am keeping you in my thoughts and prayers!!!
 

kirstynkoffs

New member
So then they wonder why they have needle phobic cf adults?! This issue makes me furious to the point I am shaking. I can vividly recall many many experiences that have lead to severe trauma and mostly because people couldn't be bothered taking a little extra effort. The big thing is CF is a life-long illness. These procedures are not a one off. I can recall PICCS that have taken 8 attemps without success leaving me BLACK up both arms and across my chest, I can remember being taken away from my parents SCREAMING to have PICCS placed in ICU "where they have better dr's" (icu is a scary place for a child) and I have had regs say "you will need to be patient I haven't really done this before" before asking the nurse what he will need - needless to say he was given marching orders. My point(s) is no1 cares for you or your child the way you do. I got to the point where as a young adult/teenager I would rather be sick than admitted (which HAS done lung damage) and eventually my adult cf dr realized this and was happy to order a full anesthetic, although sometimes I would have to wait a few days to get on the list. This helped but with declining lung function is a big risk.

I have recently moved to a bigger cf centre where I have now had 3 admissions. They have a specialised PICC team who do 10 plus every day. It is usually one of three doctors who do it, I have met them all now. The first two times the PICCS went in first shot both times (under sedation). The last time I requested no sedation. I felt I had built a trust with the PICC team and asked only to have sedation on hand if a second attempt was required. MORE importantly I requested a trusted CF team member be present to ensure they would STOP if I wanted them to. 15 minutes 1 PICC no sedation no pain. It has taken 15 or more years to get to this point. I can't help but think if people had done the right thing from the start whether the concept of a PICC would have had to be a stressful traumatic thing - at one stage in my teenage life I was so scared of veins and anything picc related I was having panic attacks even when I was healthy and didn't need an admission.

After ALL that my advice would be. Sedation is important. As I said CF and the the crappy procedures that go with it are life long. Why be exposed to unecessary trauma? YOU are your daughters best advocate, it's tough but don't feel pressured... The staff pressuring you deal with it for a minute, sorry if sedation is a pain for them but sure as he'll they won't be the ones dealing with nightmares and anxiety for years to come. You are well within your rights to ask for sedation...(try and negotiate it before if possible) They don't like it tough. Only allow someone who has LOTS of experience with PICCS... Your daughter is not a training doll. IMO at least a few a week is the MINIMUM... If they get shirty when you ask about their experience maybe you don't want them doing it? And finally if your daughter has tricky veins ultrasound guided is the only option.

I'm sorry this is long. I hope it doesn't come accross 'lecturey' I have just had so many bad experiences that had a very lasting impact and would hate for others to go through anything that could possibly be avoided. So many other cfers could tell very very similar stories<img src="i/expressions/face-icon-small-sad.gif" border="0"> best of luck xxx
 

kirstynkoffs

New member
So then they wonder why they have needle phobic cf adults?! This issue makes me furious to the point I am shaking. I can vividly recall many many experiences that have lead to severe trauma and mostly because people couldn't be bothered taking a little extra effort. The big thing is CF is a life-long illness. These procedures are not a one off. I can recall PICCS that have taken 8 attemps without success leaving me BLACK up both arms and across my chest, I can remember being taken away from my parents SCREAMING to have PICCS placed in ICU "where they have better dr's" (icu is a scary place for a child) and I have had regs say "you will need to be patient I haven't really done this before" before asking the nurse what he will need - needless to say he was given marching orders. My point(s) is no1 cares for you or your child the way you do. I got to the point where as a young adult/teenager I would rather be sick than admitted (which HAS done lung damage) and eventually my adult cf dr realized this and was happy to order a full anesthetic, although sometimes I would have to wait a few days to get on the list. This helped but with declining lung function is a big risk.

I have recently moved to a bigger cf centre where I have now had 3 admissions. They have a specialised PICC team who do 10 plus every day. It is usually one of three doctors who do it, I have met them all now. The first two times the PICCS went in first shot both times (under sedation). The last time I requested no sedation. I felt I had built a trust with the PICC team and asked only to have sedation on hand if a second attempt was required. MORE importantly I requested a trusted CF team member be present to ensure they would STOP if I wanted them to. 15 minutes 1 PICC no sedation no pain. It has taken 15 or more years to get to this point. I can't help but think if people had done the right thing from the start whether the concept of a PICC would have had to be a stressful traumatic thing - at one stage in my teenage life I was so scared of veins and anything picc related I was having panic attacks even when I was healthy and didn't need an admission.

After ALL that my advice would be. Sedation is important. As I said CF and the the crappy procedures that go with it are life long. Why be exposed to unecessary trauma? YOU are your daughters best advocate, it's tough but don't feel pressured... The staff pressuring you deal with it for a minute, sorry if sedation is a pain for them but sure as he'll they won't be the ones dealing with nightmares and anxiety for years to come. You are well within your rights to ask for sedation...(try and negotiate it before if possible) They don't like it tough. Only allow someone who has LOTS of experience with PICCS... Your daughter is not a training doll. IMO at least a few a week is the MINIMUM... If they get shirty when you ask about their experience maybe you don't want them doing it? And finally if your daughter has tricky veins ultrasound guided is the only option.

I'm sorry this is long. I hope it doesn't come accross 'lecturey' I have just had so many bad experiences that had a very lasting impact and would hate for others to go through anything that could possibly be avoided. So many other cfers could tell very very similar stories<img src="i/expressions/face-icon-small-sad.gif" border="0"> best of luck xxx
 

kirstynkoffs

New member
So then they wonder why they have needle phobic cf adults?! This issue makes me furious to the point I am shaking. I can vividly recall many many experiences that have lead to severe trauma and mostly because people couldn't be bothered taking a little extra effort. The big thing is CF is a life-long illness. These procedures are not a one off. I can recall PICCS that have taken 8 attemps without success leaving me BLACK up both arms and across my chest, I can remember being taken away from my parents SCREAMING to have PICCS placed in ICU "where they have better dr's" (icu is a scary place for a child) and I have had regs say "you will need to be patient I haven't really done this before" before asking the nurse what he will need - needless to say he was given marching orders. My point(s) is no1 cares for you or your child the way you do. I got to the point where as a young adult/teenager I would rather be sick than admitted (which HAS done lung damage) and eventually my adult cf dr realized this and was happy to order a full anesthetic, although sometimes I would have to wait a few days to get on the list. This helped but with declining lung function is a big risk.
<br />
<br />I have recently moved to a bigger cf centre where I have now had 3 admissions. They have a specialised PICC team who do 10 plus every day. It is usually one of three doctors who do it, I have met them all now. The first two times the PICCS went in first shot both times (under sedation). The last time I requested no sedation. I felt I had built a trust with the PICC team and asked only to have sedation on hand if a second attempt was required. MORE importantly I requested a trusted CF team member be present to ensure they would STOP if I wanted them to. 15 minutes 1 PICC no sedation no pain. It has taken 15 or more years to get to this point. I can't help but think if people had done the right thing from the start whether the concept of a PICC would have had to be a stressful traumatic thing - at one stage in my teenage life I was so scared of veins and anything picc related I was having panic attacks even when I was healthy and didn't need an admission.
<br />
<br />After ALL that my advice would be. Sedation is important. As I said CF and the the crappy procedures that go with it are life long. Why be exposed to unecessary trauma? YOU are your daughters best advocate, it's tough but don't feel pressured... The staff pressuring you deal with it for a minute, sorry if sedation is a pain for them but sure as he'll they won't be the ones dealing with nightmares and anxiety for years to come. You are well within your rights to ask for sedation...(try and negotiate it before if possible) They don't like it tough. Only allow someone who has LOTS of experience with PICCS... Your daughter is not a training doll. IMO at least a few a week is the MINIMUM... If they get shirty when you ask about their experience maybe you don't want them doing it? And finally if your daughter has tricky veins ultrasound guided is the only option.
<br />
<br />I'm sorry this is long. I hope it doesn't come accross 'lecturey' I have just had so many bad experiences that had a very lasting impact and would hate for others to go through anything that could possibly be avoided. So many other cfers could tell very very similar stories<img src="i/expressions/face-icon-small-sad.gif" border="0"> best of luck xxx
<br />
<br />
 
M

Mommafirst

Guest
oh Kelly, reading that makes me so angry and upset. I agree, its not always easy to advocate when the doctors and nurses look at you like you are crazy. you begin to second guess yourself. Its all so unfair.

Shelly -- Akron Children's didn't do PICCS but sent you home with a regular IV? Wow. Hmmm, I hate this, I hate that you deal with it. I have it for all the kids. I really don't get why all the PICC team at children's are so insistent that this is no big deal.
 
M

Mommafirst

Guest
oh Kelly, reading that makes me so angry and upset. I agree, its not always easy to advocate when the doctors and nurses look at you like you are crazy. you begin to second guess yourself. Its all so unfair.

Shelly -- Akron Children's didn't do PICCS but sent you home with a regular IV? Wow. Hmmm, I hate this, I hate that you deal with it. I have it for all the kids. I really don't get why all the PICC team at children's are so insistent that this is no big deal.
 
M

Mommafirst

Guest
oh Kelly, reading that makes me so angry and upset. I agree, its not always easy to advocate when the doctors and nurses look at you like you are crazy. you begin to second guess yourself. Its all so unfair.
<br />
<br />Shelly -- Akron Children's didn't do PICCS but sent you home with a regular IV? Wow. Hmmm, I hate this, I hate that you deal with it. I have it for all the kids. I really don't get why all the PICC team at children's are so insistent that this is no big deal.
 

mag6125

New member
Children's didn't even have PICC nurses until I was about 14 or 15 and I was one of their first patients, I let them try twice and that was it never went back. Akron General's PICC team does them all day long and they're wonderful. I guess things have just changed so much since I was Alyssa's age, I always had a normal iv at home with a homecare nurse who came out to change the dressing every couple of days. Eventually my veins got too bad and the meds were too rough and that's when we turned to PICCs but it was never even mentioned when I was young.
 

mag6125

New member
Children's didn't even have PICC nurses until I was about 14 or 15 and I was one of their first patients, I let them try twice and that was it never went back. Akron General's PICC team does them all day long and they're wonderful. I guess things have just changed so much since I was Alyssa's age, I always had a normal iv at home with a homecare nurse who came out to change the dressing every couple of days. Eventually my veins got too bad and the meds were too rough and that's when we turned to PICCs but it was never even mentioned when I was young.
 

mag6125

New member
Children's didn't even have PICC nurses until I was about 14 or 15 and I was one of their first patients, I let them try twice and that was it never went back. Akron General's PICC team does them all day long and they're wonderful. I guess things have just changed so much since I was Alyssa's age, I always had a normal iv at home with a homecare nurse who came out to change the dressing every couple of days. Eventually my veins got too bad and the meds were too rough and that's when we turned to PICCs but it was never even mentioned when I was young.
 

Liza

New member
Interventional radiology does Rachel's. She's sedated and she's now 20! In fact, she just had a picc line placed today. Her team orders it done this way, even when it's a same day admit. Now, sometimes they will have to put in a peripheral line for a day, but no longer than that because it becomes unusable pretty quick.

DEMAND she be sedated then make sure the doctor orders it that way. Remind who ever is placing the line when you get there that she is to be sedated, doctor's orders.

She is a little girl with CF, this is not going to be a one time thing. You, her team, her nurses don't need to have a frightened and traumatized patient on their hands. This can lead to problems down the line with her possibly delaying her own hospitalizations just because of what's happening now.
 

Liza

New member
Interventional radiology does Rachel's. She's sedated and she's now 20! In fact, she just had a picc line placed today. Her team orders it done this way, even when it's a same day admit. Now, sometimes they will have to put in a peripheral line for a day, but no longer than that because it becomes unusable pretty quick.

DEMAND she be sedated then make sure the doctor orders it that way. Remind who ever is placing the line when you get there that she is to be sedated, doctor's orders.

She is a little girl with CF, this is not going to be a one time thing. You, her team, her nurses don't need to have a frightened and traumatized patient on their hands. This can lead to problems down the line with her possibly delaying her own hospitalizations just because of what's happening now.
 

Liza

New member
Interventional radiology does Rachel's. She's sedated and she's now 20! In fact, she just had a picc line placed today. Her team orders it done this way, even when it's a same day admit. Now, sometimes they will have to put in a peripheral line for a day, but no longer than that because it becomes unusable pretty quick.
<br />
<br />DEMAND she be sedated then make sure the doctor orders it that way. Remind who ever is placing the line when you get there that she is to be sedated, doctor's orders.
<br />
<br />She is a little girl with CF, this is not going to be a one time thing. You, her team, her nurses don't need to have a frightened and traumatized patient on their hands. This can lead to problems down the line with her possibly delaying her own hospitalizations just because of what's happening now.
<br />
<br />
 

Ratatosk

Administrator
Staff member
DS had to have a PICC because he got put on TPN for a week during his bowel obstruction. That stuff can't go thru a regular IV. Then they kept it in to administer antibiotics because his ivs don't seem to last very long before getting inflammed. I'm hoping the poor kid doesn't have my illusive rolly veins and that it's just an age thing.
 

Ratatosk

Administrator
Staff member
DS had to have a PICC because he got put on TPN for a week during his bowel obstruction. That stuff can't go thru a regular IV. Then they kept it in to administer antibiotics because his ivs don't seem to last very long before getting inflammed. I'm hoping the poor kid doesn't have my illusive rolly veins and that it's just an age thing.
 

Ratatosk

Administrator
Staff member
DS had to have a PICC because he got put on TPN for a week during his bowel obstruction. That stuff can't go thru a regular IV. Then they kept it in to administer antibiotics because his ivs don't seem to last very long before getting inflammed. I'm hoping the poor kid doesn't have my illusive rolly veins and that it's just an age thing.
 
M

Mommafirst

Guest
Kirstyn and Liza -- thank you both for chiming in. You are right, I need to demand it next time. I know what she needs... its just not okay to traumatize her like this.

She's really blue today. She had a meltdown when it was time to do meds. She's hating this disease, but doesn't even know how to articulate it. I think I need to find a therapist to help her or us or something.
 
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