PICC lines

nurs4kids · Nov 4, 2001

I'm not sure what you're wanting, but for the basics. They're wonderful for kids on long term therapy because of the limits of peripheral IV access. You have the same benefits of a central line without the necessity of sedation and/or surgery. Only bad thing that I've seen vs a central line is that the smaller ones are almost impossible to draw blood from because the line will collapse under minimal pressure.

What else are you wanting to know???

skap · Nov 8, 2001

I have a lot of experience with PICC lines - using them that is. All of our CF patients get PICC lines the day that they are admitted for their antibiotic therapy. They are nice and easy to use. Great for blood draws and you don't really have the risk of infiltration like a regular IV. The kids like them because they are out of the way and since it's in their upper arm, there hand isn't taped up because of an IV. I much prefer a PICC over an IV, especially for long term abx therapy. I think the patients and parents do too.

KRVRN, BSN, RN · Nov 8, 2001

We use them in the NICU a lot. They usually put them in preemies for long term TPN infusions once they d/c the UVC. They are nicer than peripheral IV's because PIV's usually don't last more than a few days on the babies. They are very tiny though. You can't draw blood from them and, in fact, we only TRY drawing blood from them if we want a blood culture off of the line. We also won't infuse blood through them because supposedly they're too small of a lumen. Although blood cells are awful small so I don't doubt that other NICU's do it. I'm sure in bigger peds they can use PICC's for blood transfusions.

If they can't hit a vein in the arm or leg they will sometimes put a PICC in the baby's scalp. I still think it's a little freaky knowing that a scalp PICC is threaded all the way down the baby's head and neck.

nurs4kids · Nov 9, 2001

KRVRN,

Thanks for confirming that I'm not an idiot about the lumen being too small to draw blood :) . We DO draw labs from the PICCs of the bigger kids. A scalp PICC???? Wow! Not to say our NICU doesn't do it, but I've never seen a scalp PICC (I'd think I would have gotten one on transfer if they did). I HATE scalp IV's anyway, I couldn't imagine a scalp PICC.

Tracy

okay, my coworker (sitting over my shoulder) just informed me that he has had a patient here with the scalp PICC...guess I've just missed those pt's.

KRVRN, BSN, RN · Nov 9, 2001

Well, the scalp PICC's aren't quite as bad as the scalp PIV's because you don't have to assess the site as closely. I personally like to leave a scalp PIV completely uncovered so I can watch it for infiltrating, but I don't mind covering the PICC's with a hat since I'm not as worried about it infiltrating. I've only seen a few scalp PICC's and they were on the side of the head.

nurs4kids · Nov 10, 2001

LOL..I admitted a transfer tonight that's just had a scalp PICC pulled, so I guess I was wrong.

APinkston · Nov 26, 2001

Last week in my Ped. rotation, I had a 3 1/2 month old with a PICC line in his upper arm. This was the first time I ever saw a PICC line, so I don't have much experience with them. The day I was caring for the patient, no fluids were being administered through the line because it was clotted. The patient's PICC line was flushed with NS, then the clot was withdrawn, then a heparin flush was administered. There wasn't any complications with unclotting the line. Apparently, the PICC lines often get clotted and it has to be taken out.

Lanurse0417 · Jan 6, 2007

Anyone know what type or size piccs they are using for the neonates and if the are using ultrasound guidance or anticubital sticks only. Trying to expant to do more neonates and smaller children and just looking for help with this.

babynurselsa, RN · Jan 6, 2007

The typical size is a 1.9 fr.

When I was placing them we did not use u/s. I haven't placed one in a bout 3 years, so obviously they may be now.

lovemyjob · Jan 8, 2007

Our facility also does not do it under ultrasound guidance. Our PICC nurses put them pretty much where ever they can get them, arms legs, scalp. Sometimes they are put in by surg via cutdown where they isolate the vein and then place the picc, knowing exactly the vein they are going for.

perfectbluebuildings, BSN, RN · Jan 17, 2007

If they cannot get one in surgery on some kids in our hospital, they will often have the radiologist put it in under fluoroscopy the next day.

I love PICC lines!! I do feel bad for some of the kids who have had several and are "hard sticks" because they will come back from surgery with bruises and very sore arms from 5+ sticks, when one particular RN is working, but I would say they are much happier with that than being stuck over and over for PIVs!!

A lot of the CF patients and families like them because they can take care of them at home and not have to stay inpt the whole 3 weeks of antibiotics, if they are comfortable with it (and capable of it!)

One of our older patients has a double-lumen tunneled PICC that she can keep for up to a year- do you know much about those, have you had any patients with them? I think they put it in b/c the pt has poorer lung function and resp. "issues" last time they had surgery, and also is having more exacerbations so it would be hard to keep on sticking. I am not sure why they decided against a port in this case... OK I am rambling, sorry.