Clinical Procedure
 
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In neonates and infants the large curvature of the kit guidewire can cause it to become stuck in the narrow diameter vessels.

A two stage technique with a 3fr PICC conversion kit can help overcome this.

1. Access the vein with a 22g cannula and advance the straight wire and dilator/sheath from the PICC conversion kit.

2. Remove the dilator and wire and insert the larger wire from the vascath kit (it exits the sheath in a more proximal and larger diameter vessel )

3. Use the larger guidewire to run the larger dilator and insert the vacath.

This, in essence, is using the sheath from the PICC conversion kit as a means of delivering the end of the larger curved wire into a more proximal vessel.

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When inserting a vascath ensure it is heparin locked.
Even a small delay in getting flow through the vascath may result in clot obstructing the catheter.

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