hope you are having better sleep now that you've got lots of information. it may seem very obvious but if you've still got your bard workshop book, you'll find all your answers there.
are you inserting the piccs peripherally or with ultra sound as each would give you different lengths to insert (the higher above the ante cubital fossa you go, the shorter the length to be inserted.
this is how i measure my lines
asuuming i'm using a peripheral cannula (therefore belove or just aboce the acf),with the arm at 90 degrees, measure the distance from the insertion site to the head of the humerus across to the sternoclavicular junction (bard). in miss dubbie's language-measure from the chosen vein site to the sternal notch, from the sternal notch to the lower third intercostal space and the total of both measurements is the length of line i insert.
**i was taught to add extra 2-3 cm if using the left arm for same reasons explained earlier in the forum.
re documentation- bard has a sticky label in the picc pack all you need to fill in is the lot number, date of insertion and name of clinician.
in the medical notes, i always make sure i include the following:
local anaethetic used
what skin is cleansed with
number of attempts before successful picc insertion
amount of bleeding
back flow/ability to confirm placement
lenth of picc inserted
lenght of line cut off 9(if applicable), length of line from exit to hub
medications and flushes administrated,
strength of heparinisation 9if required)
type of bung/cap used
then in bold letters, i write :chest x-ray ordered to confirm correct position of picc before use. dressing to be changed 24 hrs post insertion (***please apply pressure pressure dressing if excessive bleeding noted but leave dressing in situ for 24 hrs). dressings to be changed every 7 days please unless otherwiae indicated.
do let me know if i've missed anything- best thing about this forum is we learn from eachother