Elevated INR and RN PICC placement

[regnifne]

As a Registered Nurse placing PICCs at bedside, how high is too high for an INR? At what point do you refer the patient to the radiologist?

[maciv]

On our IV/Picc team we do not have a cutoff,it depends more on the pt's anatomy and can we place it with one stick,the bleeding can be controlled at the insertion siteand sometimes the INR can not be reversed,doing so would put the pt at risk.It really is a judgement call on the nurses part after careful assessment of the pt's whole clinical picture.

[arms]

Where can I be trained to place PICC line. I am very very enthusiastic to do PICC line placement. I salute to nurses who do PICC lines really.

[pennym]

I agree with CoronaPeng in that it is much safer to place a PIcc than

to have the DR place a subclavian. I once did a Picc on someone whose

Platelets were 1----I had only been doing Piccs for about 6 months and I

was nervous. I had a closure patch---a collagen patch used in post caths

sometimes. It was awesome ----she hardly oozed at all. I checked her

picc frequently the next 2 days and it was remarkable. So don't panic

if they have low platelets. The highest INR I ever placed a picc in

was 8 and that pt did fine. See Ya:twocents: