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A short PICC line ?

Posted

I once saw a nurse insert a PICC line that she intended to terminate in the subclavian vein. I thought she was calling it a "half-PICC line". Is that the proper term, and is it common? It ran up the basilic vein to terminate in the subclavian vein. I wonder why it was not extended to the vena cava.

MunoRN, RN

Specializes in Critical Care. Has 10 years experience.

That would be a midline, not a type of PICC since a PICC by definition has a centrally positioned tip. Midlines vary, as do the definitions, but typically any line longer than 3 inches, but with a tip that is short of the cavoatrial junction (or the SVC depending on definition) is often considered a midline.

Here.I.Stand, BSN, RN

Specializes in SICU, trauma, neuro. Has 16 years experience.

That would be a midline, not a type of PICC since a PICC by definition has a centrally positioned tip.

I remember in new grad class being told we might hear the term "Midline PICC" on the floor. The IV nurse teaching that portion made it very clear, "A midline is not a PICC."

At that hospital, for midlines they put a blaze orange sticker on the extension, looked like the date labels for IV tubing, except it had pre-printed "THIS IS A PERIPHERAL IV" ;)

IVRUS, BSN, RN

Specializes in Vascular Access. Has 32 years experience.

But a MIDLINE SHOULD NEVER terminate or stop in the Subclavian. A midline IV catheter is 3-8 inches in length and should never pass the axillary vein, or the shoulder. Having any IV catheter stop in the subclavian or the innominate vein is wrong as it is associated with a huge increase I thrombosis rate. The "nurse" placing the PICC should ALWAY aim for the SVC.. Nothing else is acceptable.

Thanks to all of you for the lessons. "Midline" sounds familiar now. I could be wrong, but I thought the nurse cut the catheter to target the subclavian vein. I will keep in mind that it might be a poor practice to do that.

I want to add that a PICC line should not be cut to be a midline. This is not what the line was intended.

I agree with Texas! and IVRUS, the subclavian is totally inappropriate, as is using a PICC as a midline. This leads to potential confusion and complications.

There are midline catheters and they should be used as such. Why use a PICC at about 3-4 X the cost than a proper midline?

I agree with Texas! and IVRUS, the subclavian is totally inappropriate, as is using a PICC as a midline. This leads to potential confusion and complications.

There are midline catheters and they should be used as such. Why use a PICC at about 3-4 X the cost than a proper midline?

sometimes if we can't get a picc to thread for some reason, we will convert it to a midline. We always make sure it's clear in epic that it is a midline and we also label it as such.