Are PICC's becoming contra-indicated

[ntkhansarik]

I had an interesting comment made to me this morning. I was told by a staff office nurse, that she was told by her doctor and had read an article that stated recent studies show PICC's are becoming a thing of the pass and are contra-indicated. That Central lines are safer. I asked her to please fax her source to me, haven't seen it yet. Please help.

[iluvivt, BSN, RN]

Actually the exact opposite is true. First,a PICC is a central line. There are lots of places in the human body to access a vein and then advance it into the central circulation (optimal tip placement is the distal Superior Vena Cava). A port, is also a CVC as are Hickman Broviacs Chest Groshongs etc. PICCS have become increasingly popular in part due to their low infection risk. There are several reasons for this....different resident bacteria on the arm as opposed to chest and groin bacteria,lower body temperature when compared to other sites..lower amt of sweat and oil glands and the PICC is away from the patients face and thus their respiratory secretions. The newer catheter materials have also improved with promises of decreased thrombogenicity. Also technology has allowed us to use Ultrasound,virtually eliminating the complication of sterile phlebitis. The latest research and CDC recommendations also support and prove this view. Every once in awhile a researcher can make flawed conclusion so it is always important to read a variety of research. The reason I am saying this is b/c I bet the MD read some kind of research article or as a lack of understanding of the subject. There are a lot of MDs that need to be educated on the proper use and maintenance of CVCs and many hospitals are now mandating that they use maximal barrier precautions when inserting any CVC.

With this in mind there are contraindications such as SVC syndrome.recent mastectomy and the need to preserve arm for graft or shunt. those are just a few.