Can you tell me if you have a magic number you follow in your facility for the minimum platelet count that you will place a PICC line for a patient with Heparin induced thrombocytopenia. Thank you in advance. Robin
we typically do not place picc's in patients with platelet counts less than 20, however each patient is looked individually - I don't think you can have a magic numbe, however, obviously extemely low patients may require some intervention priot to line placement if able to obtain a PIV. There are some patients whose platelets are chronically low (cancer pts), yet a picc is still the safest choice for a central line for them as you can control any bleeding from a peripheral site much better than anywhere else. I would say that if your facility is still using Heparin flushes to "lock" your catheters with, I would advise caution about placing a picc line that would require this due to their HIT
It is important to remember that HIT is an immunological problem, not a bleeding problem. Yes, the immune response is decreasing the platelet count, but bleeding is not the problem. Clotting is the problem. So I would not be concerned about placing a PICC in a patient known to have HIT.
It is important to remember that HIT is an immunological problem, not a bleeding problem. Yes, the immune response is decreasing the platelet count, but bleeding is not the problem. Clotting is the problem. So I would not be concerned about placing a PICC in a patient known to have HIT.
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