Attempted PICC line placement on very muscular gentleman. Arm measured 41cm. Veins on ultrasound were 21/2cm or deeper. I was very careful not to apply pressure with the probe. I use mst and ultrasound when placing. I have the siterite 5. Any tips on placing PICC lines on muscualr patients.  Would love any help. Â
What was the problem? You don't give us any idea what happened other than the patients dimensions. (and what a nice muscular arm if the circumference was 41cm!)
What product were you using?.....what length of introducer? which vein?
Was it getting into the vein or advancing the catheter?
Susan Schuetrumpf, RN, CRNI, VA-BC
Atlanta GA
I could only access the basilic vein one time and then the guide wire did not thread. I was using a 21 gauge microintroducer kit and had planned to place a single lumen 4 fr. groshong picc. It would appear on the ultrasound to have entered the vein, would then attempt a through and through with no luck. Then switched to 21gauge introducer from the nitonel kit. Still no blood return. Hope this information helps.
We have had good success when inserting piccs on larger patients when we use pressure if necessary with the transducer, but pass the guidewire before lifting the transducer at all. We also use the microintroducer kit.
Kelly Smith
PICC Nurse
Boone Hospital Center
Columbia, Missouri