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Insertionof PICC when percutaneous central line in situ


Are there any recommendations relating to the insertion of a PICC when an IJ or subclavian line is already in place ( PICC to replace said line) Should it be removed before the PICC is inserted or can it be removed after? I do have concerns about removing line after PICC is in, but there is a niggling concern about removing one access device before a new one is inserted. Can anyone offer any insite? 

Thank you! 

Kerry McDonald

there is no guidance from

there is no guidance from standards, etc about this so it is really a judgment call. Most of the time, my choice was insert PICC, then remove CICC, then get the xray if ECG now used. Removal of the CICC can cause PICC tip to migrate. 

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861



that is what I have been doing, glad to know you concur. 

With thanks, 



K. McDonald RN


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