Patient assessment for PICC line insertion

[frankie]

I am interested in patient assessment pre - PICC line insertion. Does anyone do a telephone assessment? scheduled appt? On the spot speedy assessment? And - what do you include - labs, meds, etc...???? thanks frankie

[jemb]

Unfortunately, we frequently don't get a chance to do any assessment before the patient arrives at our clinic for PICC insertion. When we do see the patient prior, we do a simple assessment of the veins (as in anything promising there?), and assess the patient's upper extremitiy ROM for procedure positioning. I also like to ask them about meds -- warfarin, ASA, etc. The docs are supposed to do this before they send them to us, but sometimes they don't .

[frankie]

jemb - we are in the same boat. I really wanted to get a tele assessment, just to prepare, but it seems to be one thing too much. I know RNs who do this in some of the more rural hospitals here in MD, but we just are not able - and the docs send them in. thanks for taking time to answer - frankie

[lisaloulou]

Hi Frankie

Id be interested to know how your team is set up to do PICC lines. I work in a radiology associated team.

[hansenbitten@ao]

I WOULD REALLY LIKE TO KNOW NURSING PARAMETERS CONCERNING PICC LINES IN CHILDREN..ON ANADULT I MEASURE 6 IN FROM THE INSERTION SITE AND RECORD DAILY AS ASSESSMENT OF INSERTION AND INFILATRATION, WHAT DO YOU DO WITH A CHILD SINCE 6 INCHES IS NOT ACCAEPATBLE SINCE THE SIZE OF ARMS ARE SO MUCH SMALLER.WHAT OR WHERE WOULD A GOOD PLACE BE? [email protected]

[nursesearl, BSN, RN]

hansenbitten,

I think children would be same as adults, mid-arm circumference.

Frankie,

As for pre-assessment tool, we ask the following:

1.Dominant hand

2.Any fractures, dislocations or other trauma to either arm or shoulder?

3.Radiation therapy to the arm or chest area?

4.Problem veins (fragile, rolling, tough) with blood draws, IV therapy or when donating blood?

5.How long is the therapy planned to last?

6.Does the patient intend to resume activities that would require heavy lifting, vigorous arm movement, etc that would impact on the catheter placement?

7.Does the patient have any underlying medical problems: AIDS, cancer, diabetes, liver/kidney disease or recent chemotherapy?