Head position in PICC placement

  1. I usually position the pt.'s bed at a 30 degree angle, but I have seen other PICC nurses position higher than this. I am curious as to what other experts use for pt. positioning and whether a higher angle decreases chances of PICC going up the neck.
    Thanks!:spin:
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  2. 3 Comments

  3. by   piccman
    Quote from blsmom
    I usually position the pt.'s bed at a 30 degree angle, but I have seen other PICC nurses position higher than this. I am curious as to what other experts use for pt. positioning and whether a higher angle decreases chances of PICC going up the neck.
    Thanks!:spin:

    In my experience, a higher HOB angle does not always increase chances of PICC threading to the SVC. I actually lay to about a 5-10 degree HOB angle before I thread the PICC past the shoulder. I USUALLY have better results with this approach.

    sam
  4. by   sbivrn
    Interesting. I place the patient completely supine, except in cases where the patient cannot tolerate it. When making the turn at the shoulder I have the patient turn their head toward me and angle the chin down to the shoulder. This almost always works like a charm. I have had to sit the patient comletely up to get a line to drop, but it is rare. If the patient is not able to follow commands I have a nurse come in to help position the head.
  5. by   CritterLover
    whatever is comfortable for the patient.

    i've placed them with the hob flat, i've placed them with the patient in a chair (both recliners and wheel chairs).

    i'm not very particular about hob. in fact, i would have to say that i go with whatever angle the hob is at when i walk into the room.

    haven't noticed much of a difference as far as svc vs jugular placement.

    i rarely place the line in the jugular vein.

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Head position in PICC placement