When it comes to confirming the placement of peripherally inserted central catheters (PICCs), should radiology departments strive to use fluoroscopy rather than radiographs?
Dear X-ray Insider,
When it comes to confirming the placement of peripherally inserted central catheters (PICCs), should radiology departments strive to use fluoroscopy rather than radiographs?
The question may be moot for facilities that already rely on fluoroscopy, and for those where fluoro isn't an option. But for those in the middle, this month's X-ray Insider Exclusive may be of interest.
While researching practice variations in PICC placement, I had the good fortune to discuss the issue with Dr. John Racadio of Children's Hospital in Cincinnati. His facility has long used fluoro for most of its PICC placements, and soon will provide that service even in the neonatal intensive care unit.
Racadio is also authoring an article for an upcoming issue of Radiology that compares the accuracy of bedside versus fluoroscopic PICC placements in pediatric patients. Based on his own experience, Racadio suggests that facilities may want to rethink any assumptions regarding expense.
"When you’re looking at the cost-effectiveness of it, you have to decide how expensive is your angiography suite per unit-time, compared to the expense that goes into doing (PICCs) at the bedside -- having to reposition it, another chest x-ray -- taking all that extra time into account," Racadio said.
For more information, including perspectives from others who simply seek to improve their x-ray confirmation, check out this month's Insider Exclusive by clicking here.
