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Sun, 12/09/2007 - 21:18

kobi888

Febrile pt. and PICC insertion

Called to do a PICC in ICU.Â They want us to insert a new PICC in the right arm and then they will d/c the exsisting PICC in the pt.'s left arm.Â Pt. has been spiking temps.Â No blood cultures have been done yet, but as usual, Dr.'s think the source of infection is from the PICC.Â I worry about seeding the new PICC line if pt. does have + Blood cultures.Â Dr.'s want new PICC asap.Â What is protocol in relation to inserting PICC's when a pt. is febrile and has not yet started on any ATBX, and what if blood cultures are positive.

Thanks

Mon, 12/10/2007 - 14:33

lynncrni

Here are the published

Here are the published guidelines:

1. Mermel L, Farr B, Sherertz R, et al. Guidelines for the management of intravascular catheter-related infections. Journal of Infusion Nursing. 2001;24(3):180-205.

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

Tue, 12/11/2007 - 19:58

SMHC IVTeam

We have the same request

We have the same request to remove and replace PICCs in a febrile patient. Are there CDC guidelines on considering other sources of infection first before pulling the PICC? This would be helpful when we discuss options with the physician before removing the PICC. We culture all the tips on the PICCs we pull and they are negative but the MDs are still ordering them removed.

Wed, 12/12/2007 - 16:47

(Reply to #3) #4

lynncrni

Yes, read the CDC guidelines

Yes, read the CDC guidelines along with the guidelines on the management of CRBSI. Lynn