What to do with leaky PICC's

[curiousgeorgeRN]

A couple days ago we placed a PICC in an elderly lady in an LTAC. Her skin is very elastic so I was not surprised that I got a call about it bleeding lightly the next day. What do you guys usually do with a slowly bleeding PICC site in an elderly patient? They had to change the dressing twice in one shift so then we tried coban and wrapped it with light pressure. Do you typically replace the entire line? If so, what is usually the time frame/window? I know this thing is in the right place but I can't help but worry...

[IVRUS, BSN, RN]

A couple days ago we placed a PICC in an elderly lady in an LTAC. Her skin is very elastic so I was not surprised that I got a call about it bleeding lightly the next day. What do you guys usually do with a slowly bleeding PICC site in an elderly patient? They had to change the dressing twice in one shift so then we tried coban and wrapped it with light pressure. Do you typically replace the entire line? If so, what is usually the time frame/window? I know this thing is in the right place but I can't help but worry...

Do you mean that her skin was very 'inelastic"? Because of this issue in the elderly, bleeding is a distinct probability. Are her coag's off too? Sometimes a tapered PICC can be good in instances as this as the PICC will widen at the exit to decrease the hole made at the site. Usually, however, the body will seal itself. Within 48 hours the hole is closed around the PICC. Did you MST, or do it traditionally with a 14, or 16 gauge introducer?

Bioseal at the site may also be of help... Check out their website.

http://www.biosealcvc.com/

If bleeding continues, then replacement may be necessary.