Long term vs short term PICC's???

Gompers, BSN, RN · Apr 10, 2004

I don't work in IV therapy, I work in NICU but I deal with PICC lines all the time. Does your grandmother still require IV medication or nutrition? Because if not, I can understand them pulling it. PICCs are meant for long term, but only if they are needed. In NICU, we'll put them in sometimes and they'll stay in for months if the baby needs it, but other times we'll pull it in a week if there is no medical reason for the kiddo to have it. So maybe your grandmother's therapy was finished so they pulled it?

PICC lines are very thin and easily clotted off, so it's not a good idea to leave in if they aren't being used. If she had a bigger line straight into her chest that was very thick it might be okay because those don't clot as much, or if she had a port under her skin of course that can stay. But to leave a central PICC line in when it's not needed is a setup for infection or clotting.

Hope she's feeling alright.

Loribabble · Apr 10, 2004

Hi Gompers - thanks for the reply... it's pulled and I am ok with that now - thanks to some information from some really nice people on this board.

I can understand them pulling the line 'cause she wasn't using it, and because of the higher risk for infection/clots but the doc told my mother and grandmother that the PICC that was inserted was NOT DESIGNED for long term use (exact words). I have never heard of such a thing... I have been asking around at work and they haven't either... was wondering anyone else has heard?

Anniekins · Apr 10, 2004

I am thinking the line to her heart was the SWAN line. ??

I'm not sure why they put the picc in in the first place! Hmmmmm ? :uhoh3:

What was her Dx/reason for hospitalization?? Maybe they anticipated long term IV treatment....even after d/c and that changed?

Maybe to make blood draws easier and less painful??

Loribabble · Apr 10, 2004

They put the PICC in because she was DX with lung cancer and superior vena cava syndrome - that with her CHF she blew up like a balloon and there was no way they were going to get blood or a line in her fragile veins (long term steroid therapy) - they thought it was for chemo - but she wanted nothing to do with that and they were using it for blood draws. I was hoping they would leave it in as we have been told she has roughly 6 months to live and we wanted it for IV morphine.... earle58 has been great about explaining other options so for now I am ok that it is gone.... just don't appreciate what the docs are saying about it not being "designed for long term use"

jemb · Apr 10, 2004

I'm wondering if those were really the doc's words, or just the way your mom and grandma 'heard' it. I'm amazed sometimes at things that our patients claim were said to them, but after discussing specifics, I'm usually able to understand what was misinterpreted.

For example, the doc may have said "The line wasn't supposed to stay in a long time". The doc may have been thinking that her chemo ( had it been given) would have lasted only a certain amount of time, then the line would have been pulled. In our clinic, we remove the PICC the very day chemo is completed.

The patient may have 'heard' this as "The line wasn't designed to stay in a long time", thinking it had something to do with the line itself instead of the purpose for which it was inserted. (Remember playing 'telephone' when you were a child?)

If you need to put your mind to rest with this, why don't you call the doc and find out if this was a misinterpretation of what was really said?

mm nurse · Apr 18, 2004

No. you aren't brain dead. A true PICC line is inserted to just above the heart into the superior vena cava (SVC). It is possible that it migrated into your grandma's heart but that usually causes cardiac irratability w/ obvious signs & symptoms. Even if this was the case, all that needs to be done is for the PICC line to be pulled back a few cms and recheck the x-ray. As far as a PICC line being short term, they are considered intermediate because they are used for any IV access of >1wk and may last a year or longer. They are also able to be placed in the home environment. As far as pain control, Mso4 may also be given by continuous sub-q infusion. Midlines are a shorter version of a PICC and they are usually only threaded 5-10 inches into the upper arm. My experience w/midlines is that they don't last as long and seem to have more complications. Give me a PICC anytime!! Good luck w/ your grandma!! Mollie