Midclavicular tip location is not recognized by the INS standards as an acceptable tip location. The AVA position paper on PICC tip location is in opposition to midclavicular lines and now we have the case report of a midclavicular line causing a young pilot to loose his career due to vein thrombosis and complex regional pain syndrome. I would urge you to immediately stop the use of all midclavicular lines. The only time this tip location should be considered is when anatomical and pathophysiological reasons prohibit proper tip location in the SVC and all other factors such as type and length of therapy has been carefully considered. Lynn
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