Lately, our radiology department is using actual PICC catheters as tunneled catheters. While it's understood that this is not a PICC, our staff is confused as to how to treat this line. Our PICC team cares for PICCs and inserts and removes them. We do not touch central lines or tunneled catheters. We change PICC dressings every 7 days and our PICCs can stay in up to one year. However, while using a PICC catheter as a tunneled catheter, should our picc team be responsible for dressing changes? How long can it stay in? As long as our piccs stay in or our tunneled catheters? Should radiology pull them out since they insert them as well?  Basically my question is, just because an actual picc catheter was used, does it mean we treat it that way or do we treated as any other tunneled catheter? And what should it be called as radiology is calling it a "tunneled picc". We disagree on this.........believing that it should just be called a "tunneled catheter" or even as far as a tunneled PICC catheter", but NOT just a "tunneled picc".  Â
 Any thoughts?
A catheter labeled as a PICC can easily be placed with a short subcutaneous tunnel. This is more prevalent in IJ insertions in patients with actual or impending renal failure. The reason is to avoid passing a catheter through the subclavian vein and the subsequent risk of vein thrombosis. The difference is that these PICCs do not have a subcutaneous cuff, so there is nothing to anchor them or prevent infection other than your stabilization device and dressings. So I would say these require the same level of care as any other PICC. There are no recommendations for the maximum length of dwell for any central venous catheter, so they should be removed when no longer medically needed or when there is a complication. Since there is no subq cuff, they are usually removed by just pulling them out and do not require dissection of the cuff. So this can be done by a competent nurse. A tunneled PICC would be an adequate name in my opinion so as not to confuse them with a tunneled cuffed catheter.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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