Trimming PICCs

[travelinjones]

I recently d/c'd a PICC and found the tip was missing. Oh My! The facility uses paper documentation, and apparently the dog ate the original PICC insertion document. The patient had been in the hospital for quite a long stay, and multiple transfers, so who knows where that documentation went. We confirmed the PICC was indeed completely d/c'd by CXR. Whew!

Having never seen this practice, I was wondering is it common? Can anyone of you Infusion/IV/PICC practitioners provide rationales that support trimming over coiling the excess on the outside of the patient. What are the manufacturers recommendations?

[iluvivt, BSN, RN]

you did discontinue an open-ended PICC.Most PICCs on the market today are indeed trimmable meaning that the PICC nurse can trim the distal end (usually) prior to insertion to fit different body sizes, You probably are referring to the Groshong BARd PICC which has a distinctive rounded black tip that is the 3-way Groshong valve. Bard also makes a line of open-ended PICCs. They were first to make a Power injectable PICC that is purple in color (all sizes). If you know the kind of PICC it is you can tell what the distal end will look like,rememering that only the groshong PICC will have a Black tip and I think the Arrow PICC has a tapered end and all other PICCS will have a staight cut off look wheter or not they were trimmed. The groshong 4 FR PICC can be trimmed on the proximal end but will of course still have the black tip. What color was this PICC? hope this helps

[travelinjones]

I really appreciate your response. Very informative! I'm going to request an inservice for our unit from our IV team.

This PICC was blue.

[iluvivt, BSN, RN]

FYI.....The other PICCs you will see when traveling will be the PASV (pressure activated safety valve) by Boston Scientific .This PICC also has an open-end but it has a valve in the tails of the line that is pressure sensitive. BARD also has a new PICC called the SOLO power PICC...it too has valves in the tails ( a larger one to instill and a smaller one to withdraw). it can also be used for power injection but make sure you use only lumens that say power injectable 5ml per sec. For example,on the triple lumen only the middle red lumen with purple tail can be used for power injection.