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PICC placement on same side with IJ DVT

<p>I was presented with a patient with doppler study that showed a RT IJ DVT. The left arm is not an option as there is an existing Lt chest AICD. Our hospital policy does not allow PICC placement at the bedside on same side as pacemaker/AICD. Would you place a PICC on the right? &nbsp;My position is that it is not safe for the patient to place the line at the bedside because the line could go in the IJ, and potentially result in Embolus. My opinion is that line would be better placed by interventional radiologist using fluoroscopy.&nbsp;</p>

Is your policy about avoiding

Is your policy about avoiding the side with a cardiac device a written and approved policy or is it an understood common practice? If it is only a common practice, I would place on the left side. Yes this is a relative contraindicaiton but it is not an absolute contraindication. In this situation, it may be the least risk. The other option is to refer to IR. They may not know about or follow your policy and insert on the left under fluoroscopy. Is the IJ thrombus located close to the junction with subclavian? What caused this thrombus? What is the chance of it extending into area of veins where PICC will pass? 

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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