Head position in PICC placement

[blsmom]

I usually position the pt.'s bed at a 30 degree angle, but I have seen other PICC nurses position higher than this. I am curious as to what other experts use for pt. positioning and whether a higher angle decreases chances of PICC going up the neck.

Thanks!

[piccman]

I usually position the pt.'s bed at a 30 degree angle, but I have seen other PICC nurses position higher than this. I am curious as to what other experts use for pt. positioning and whether a higher angle decreases chances of PICC going up the neck.

Thanks!

In my experience, a higher HOB angle does not always increase chances of PICC threading to the SVC. I actually lay to about a 5-10 degree HOB angle before I thread the PICC past the shoulder. I USUALLY have better results with this approach.

sam

[sbivrn]

Interesting. I place the patient completely supine, except in cases where the patient cannot tolerate it. When making the turn at the shoulder I have the patient turn their head toward me and angle the chin down to the shoulder. This almost always works like a charm. I have had to sit the patient comletely up to get a line to drop, but it is rare. If the patient is not able to follow commands I have a nurse come in to help position the head.

[CritterLover, BSN, RN]

whatever is comfortable for the patient.

i've placed them with the hob flat, i've placed them with the patient in a chair (both recliners and wheel chairs).

i'm not very particular about hob. in fact, i would have to say that i go with whatever angle the hob is at when i walk into the room.

haven't noticed much of a difference as far as svc vs jugular placement.

i rarely place the line in the jugular vein.