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sjklee
Retracting PICC line after occulsive dressing applied.
 I'm looking for a procedure on retracting the PICC line after insertion and occulsive dressing applied, for instance, fluroscopy placement reveals good tip position but am cxr show tip deep. Do you set up sterile field? Maximum barriers? Documented literature ?
sesymons
We just do sterile dressing
We just do sterile dressing change per protocol to pull back catheter
lynncrni
PICC insertion requires
PICC insertion requires adequate securement and stabilization of the external catheter before the dressing is applied. Therefore there would be no way to retract the PICC while this securement and dressing remains intact. In other words, if the PICC will move that easily, you have not done an adequate job of stabilizing the catheter to begin with. Just remove all securement and dressing, retract the PICC and replace the securement and dressing - the only way in my opinion. Lynn

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

sjklee
Thanks for your response but

Thanks for your response but I didn't make myself very clear. After PICC placement confirmed under fluoro to be in lower svc, stat lock device is applied then covered with sterile occlusive dressing. Later for some other reason cxr done and line seen in RA and requires retracting. At this point, do you set-up sterile field, wear hat and mask?  We had not incorporated PICC retracting after line placement is complete in our policies and have recently found cxr results different from our fluoro.We are a small department and prefer evidence based practice and write this up as a policy so we can provide consistent care to our pediatric population. Not all of these situations have been inconsistencies between the chest films and fluoro but that makes for a good description. Your responses and any guidlines you have are greatly appreciated.  

                  Respectfully, Stephanie Klee RN BSN

sesymons
set the same sterile field
set the same sterile field that you would use to do a dressing change. Pull back the catheter while you are doing your scrub and then secure the catheter and apply dressing
fentanylius
Your pat is taking a deep

Your pat is taking a deep breath during the chest xray, not during the placement under fluroscopy....think about it.

Andre

Chris Naylor
We do the same as above
We do the same as above
Heather Nichols
Also a sterile dressing

Also a sterile dressing change, but there should be a repeat film if the catheter is manipulated for legal purposes.

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