I have a patient with leukemia, platelet count of 8.  I have placed two picc lines in patient. 1st line was 5fr dual lumen power picc, easy insertion, 1 stick. No bleeding, no problems with this line. Placed second PICC on friday, platelet count still 8. 5 french dual lumen groshong picc placed. Very difficult placement, 3 attempts to basilic and 2 attempts to cephalic. Was able to place on 2nd attempt to cephalic. Pt continues to steady ooze from new picc line. No oozing from attempt sites. Let me state that I use ultrasound and mst for placement. 21 gauge needle used. Any suggestions. Have held pressure on serveral attempts, will stop bleeding and then starts back up. Thanks for any suggestions.   Â
You could try a pressure dressing,such as Coban/Coflex. Dress snugly and make sure there are frequent circulation checks to the arm.
How much of the Groshong PICC is out of the arm? Can I guess it's more than 5cm? If so,you don't have the reverse taper end to act as a plug in the insertion tract or the vein.
Good luck.
I truly believe we should not have to rely on a "reverse tapered" PICC to reduce bleeding from an insertion site. There are MST kits out there that are smooth enough to keep you from making a skin nick. We place the reverse taperd Bard PICCs, but I tell my co-workers if you are putting that PICC in all the way to the up you are really placing a 7 French catheter (if the PICC is 5 "French" double). Use a BioPatch or a pressure dressing if the bleeding is too much.
Eric
Eric