We have a patient who has had a picc in since 2005. It was ordered to be removed as therapy was complete. We were unable to remove it. We tried warm compresses twice. Only 20cm was successfully pulled. Catheter still had good blood return & flushed well. Patient c/o pain at insertion site when attempting to remove it. We sent her to Radiology. They were unable to remove it. Now she needs to have it surgically removed. Any suggestions?
Thanks,
Dawn Lentz RN, CRNI
despite intense teaching and providing the Bard patient care booklet, I had a patient whose line wouldnt come out and did as Dawn did. angio had to snake it out from the groin..and it was found to be in a knot!!!...seems the literature didn't tell him he couldnt chop wood!!!???
Cheryl Kelley RN BSN, VA-BC
Jeffery Fizer RN, BSN
After about 2 weeks of dwell, the catheter is now encapsulated with the fibrin + smooth muscle + collagen. So it is a very stable structure. With time, I think this would only become a stronger structure. It sounds as if there is a complete connection between the catheter and vein wall and the collateral circulation had taken up the blood flow. I would be very interested in what the vein looked like during this surgical removal.
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
No, there are no recommendations or guidelines that state any time frame for PICC dwell. CDC guidelines states the optimal dwell time for all CVCs including PICCs is unknown.
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