SQ Lidocaine Administration/PICC Placement

[moonbeam1125]

I am a PICC nurse at a major medical center and am looking to change our policy and procedure regarding the amount of SQ lidocaine used in PICC placements. Right now our policy is 1 ml. I would like to know how much SQ lidocaine other facilities use for PICC placement. If the amount varies from patient to patient, what criteria do you use to decide who gets how much? Thanks!

[Asystole RN]

I've never worked for a facility that had a firm restriction on the maximum amount of lido a patient could recieve. 3-5mls was generally the max ever given to any one patient, mostly because we only had on hand a 5ml ampule. 1ml for a single insertion was the common amount.

[GailAnne]

We also use a 5ml amp but use a 1ml syringe. I rarely give more than 0.4-0.5 ml. We do have a spare needle incase we need to freeze in another area, either because we change our approach or have to go to try #2.

Since the main point is to freeze for the introducer/dilator, that's all that's needed. Why add extra fluid to make the image less on the U/S.

I find the order being up to 1ml is fine as we consider it per attempt.

If you insert on peds, that order is still good, don't need a second set of orders.

[Infusion50]

In our PICC kits, we have a 5 cc ampule and draw it up in a 5 cc syringe. Most of our PICC nurses are only using .5- 1cc per injection. But, we typically do 2 injections during the procedure...#1 for the needle insertion and #2 for the introducer nick.

[HMarie13]

Same here as comment above, I use 1cc at a time. Comes in handle to have the whole 5cc if I need to stick a second time I have more available or in the rare occasion I suture.

[Ellie G]

I do two injections, one for the stick and one for the introducer of 0.5-1ml depending on the depth of the vein. Some people are more resistant to lidocaine also.