Is anyone seeing a mast cell like reaction during or shortly after PICC insertion. We have seen patients that start with coughing and then reddness over face, chest, hands and arms. Complaining of chest pain and holding their chest and neck. We had one occurence where the patient had swelling over one side of his face and eye. It passes very quickly in most cases but is most often happening immediatly after the saline flush. If you have seen this with any of your patients I would be interested to know the age of the patient, diagnosis, were they sedated at all, what was their anxiety level and what catheter were you using. Thank you so much
Yes, hypoxia and redness immediately after PICC insertion...check this site as others have seen it as well..very scary
Angela Williams RN BSN CRNI
Clark Memorial Hospital
Jeffersonville IN
Yes, we have seen many of these reactions and they are very scary. We began collecting data after we had increased frequency of the reactions. We did not find any common denominator in a particular patient population or age category. The biggest population were the cystic fibrosis and oncology patients, mostly adults. Anxiety was a factor, none were sedated. We did have one sedated child who had a significant reaction. We were using buffered lidocaine, prepared by pharmacy, and did not know if this was a factor. Hedi Chichila RN Yale New Haven Hospital
Yes, I have seen this on occasion and have noticed the patients are those who are very nervous, anxious and there has been a strong corrolation white red hair. Is this something others have noticed? What is the best way to prevent this in the future, and how do we treat this reaction as it is occuring?
Rhonda Ward, RN
Rhonda Ward
Wow, I don't believe I have ever seen this and I've been placing piccs for 20 years. We use only Bard catheters and do about 150 per month, adults only, many of which are oncology. We do not buffer our lidocaine (although I would like to).
I wonder what other things could factor into that reaction.
Darilyn Cole, CRNI
Mercy General Hospital
Sacramento, CA
Darilyn Cole, RN, CRNI, VA-BC
PICC Team Mercy General Hospital Sacramento, CA