PICC lines and k-pads

[onetiredmomma]

What is the common feeling about using k-pad use after insertion of PICCs? I have gotten different opinions from different PICC nurses. One says it helps prevent vein spasms another says it isn't important.

[HouTx, BSN, MSN, EdD]

I haven't seen any actual research on this but it seems logical. However, the application of heat can also have unintended consequences. Heat increases tissue metabolism, so it can exacerbate any pre-existing oxygenation problems. Be sure to carefully assess for signs of limb de-sat after applying heat & don't automatically assume that any c/o pain are due to vascular spasm.

[Asystole RN]

There is no suitable research regarding k-pads or other heating/cooling interventions post insertion for the prevention or management of PICC related complications such as vascular spasms.

Are you having a great deal of issues with vascular spasms post insertion? Are you sure these are vascular spams or simply pain? Where is the pain and where does it radiate? Are these traumatic insertions? What kind of PICC? Which vessel is it typically?

Asystole RN, CRNI, VA-BC

[IVRUS, BSN, RN]

Back in the 1990's, we as Infusion Nurses used kpads s/p Midline or PICC placement because we were worried about sterile mechanical phlebitis secondary to its placement. This wasn't a true phlebitis, but rather the patients response to this foreign body (the IV catheter) being in the blood vessel. We used them 4-6 times a day for 10-15 minutes at a time.

We placed a lot of the Landmark Midlines and their PICC's too, but those IV catheters were made of a special Aquavene material which was truly hydrophilic and softened and lengthened in the blood vessel once it dwelled for a hour or so.

I haven't performed this practice since 1996.