PICC line removal

[Gyh]

When is it not safe to remove a PICC line with low platelet count? Would you remove a PICC line with platelet count of 8-10? At what platelet count does it become safe to remove a PICC line?

[Asystole RN]

There are no formally recognized minimum platelet count requirements for removal or insertion of PICCs for that matter.

[Gyh]

4 minutes ago, Asystole RN said:

There are no formally recognized minimum platelet count requirements for removal or insertion of PICCs for that matter.

Do you think it would be safe to remove a PICC line at a patient's house with a platelet count between 4-8? Is there a big risk of patient bleeding from the removal?

[Asystole RN]

Just now, Gyh said:

Do you think it would be safe to remove a PICC line at a patient's house with a platelet count between 4-8? Is there a big risk of patient bleeding from the removal?

Add a dressing and then hold pressure over the top of the dressing until homeostasis is achieved. Educate the patient and family to watch for s/s and to hold pressure as needed. Having to hold periodic pressure after certain ADLs is not abnormal.

If they are unable to control the bleeding after holding pressure (for at least 15-30min) I would have them call you and/or their provider.

Is there a risk of increased bleeding? Yes. Life threatening bleeding? Not unless the wound was entirely ignored for hours/days. The risk is that it would require multiple dressing changes.

[Gyh]

2 minutes ago, Asystole RN said:

Add a dressing and then hold pressure over the top of the dressing until homeostasis is achieved. Educate the patient and family to watch for s/s and to hold pressure as needed. Having to hold periodic pressure after certain ADLs is not abnormal.

If they are unable to control the bleeding after holding pressure (for at least 15-30min) I would have them call you and/or their provider.

Is there a risk of increased bleeding? Yes. Life threatening bleeding? Not unless the wound was entirely ignored for hours/days. The risk is that it would require multiple dressing changes.

sounds good really appreciate you taking the time to give me this information! I was worried that it would bleed a lot where the PICC line enters the vein.

[canoehead, BSN, RN]

If they are expecting the platelet count to recover within a week or so, I'd leave it there (unless it was infected). You could get the bleeding stopped and have it restart later. Look for petechiae and ask about spontaneous nosebleeds, rectal bleeding too.