Hi all,
  We have a 16 bed ICU at my hospital and are placing PICCs in most of these patients. Fem lines, IJs, and subclavian are all but extinct with our fairly recent use of the triple lumen power PICCs. However, with the complexity of these patients, and thier lack of any usable peripheral veins, and the MD's desire to tranceduce CVPs, we quickly run out of ports. We have put bilateral PICC line in several patients, and it seems to be more and more common practice. 3 patients right now in ICU out of 16.Â
Have others out there had experience with this, seen any problems, or heard any chatter about a 4 lumen picc. Just courious! thanks.
Hallene E Utter, RN, BSN Intravenous Care, INC
Kathy Kokotis
Bard Access Systems
There are quad subclavian / IJ lines made by Arrow Interanational which was just purchased last week by Telflex. There are no PICC Quad lines yet. The problem is to get flow it would have to be a 7 French line. Any smaller and there are clotting issues and blood draw issues with flow. The 5 French triple lumen has the same issues.
Seven French and the right sized vessel could work but it would not work for smaller vessels. There is however a population for a 7 French quad PICC line. Any takers in manufacturing?
Kathy Kokotis
Bard Access Systems
How much larger can we allow the manufacturers to possibly make PICCs. We are already seeing triple lumens that go from 6 French to over 8 French and all of the complications that brings. INS standards say we should be using the smallest PICC possible that will allow for the treatment prescribed. If a patient needs a quad lumen catheter it needs to be a central line and not a PICC. I believe the quad lumens we use in our hospital are 8 French so with the way things are going now we should just stick those in a patient's arm like we do these power injectable purple PICCs that taper to over 8 French.
Eric
Eric