CXR verification of PICCs b/4 use

[Connie G.]

Our Hosp. policy calls for CXR verification of PICC placement before use if the patient has an existing PICC on admission. What about the interim blood draws ("using" PICC by flushing w/ NS after draw)? How about the interim q d antibiotic therapy? What is everyone else doing?

[PhantomRN]

At our facility we also require an xray prior to use if the patient admitted to the hospital with a PICC.

We do not use the PICC's for blood draws.

For a flush it is normal saline, 5cc Q shift

[Connie G.]

I need to clarify my question; I meant ... what about the OUTPATIENT interim antibiotics and blood draws. It seems unreasonable to do daily CXRs for q 24 hr levoquin.

I really appreciate your reply PhantomRN

[Chuckie]

Ya what a mess

[IVRN94]

I work on a acute care IV team and also in home infusion. My personal policy, as protection to my license, is to always verify placement. I do this in many ways. If whoever put in the PICC was kind enough to fill out the card and give it to the Pt., the information I need should be on there. If not I track down the information before I infuse anything through that line.

If at any time I suspect the line was displaced it needs another xray. If everyone monitors length of external catheter with usual paramaters for monitoring PICC, you should not have to do repeat xrays. Most important is patient education to watch for sx of displacement or migration.

Communication is key!