So we had a situation at work last night (not my patient, but I got asked for my input).
Patient has double lumen PICC line in right arm. We can't use the left arm. Patient has TPN/lipids going into one port, Amiodarone gtt into the other. Also had multiple IVPB antibiotics.
The nurse started a peripheral line in the right hand, placing the tourniquet slightly above the wrist to avoid any pressure near the PICC site.
We all know that we're not supposed to start peripherals in a PICC arm, but why? I went to several different manufacturer sites and googled it, but couldn't find the rationale anywhere. And working nights, of course there were no vascular access nurses available to ask.
The only thing we could come up with was to avoid the possiblitity of placing too much pressure on the PICC/vein when the tourniquet was used, or possible complications if the same vein was used (the peripheral was started in a different vein than the PICC was in).
It makes me nuts when I can't find the WHY behind this kind of thing, so someone help me out here please!