At my hospital, we do not place PICC lines in the ED because it is a "dirty" area. Is this the same at other institutions? I guess it is because they supposedly don't get cleaned like a regular pt. room, the curtains in there, etc. It doesn't make sense to me, though, because all pt rooms have curtains. Aren't all rooms cleaned to the same standard? I know OR rooms have a higher standards, but as it relates to placing PICCs at bedside, is an inpatient room much cleaner than an ED room?
Thanks
Rob Renander RN, CCRN, VA team
I am not aware of any guidelines that designate a certain patient area as "clean". PICCs are placed in the ED but it is not a common procedure. The reason, however, is not the issue of a "dirty" ER vs a "clean" room somewhere else. This issue is most often the emergent need for some type of line. In those cases, a subclavian or IJ CVAD is usually preferred. There could also be limited space to set up a sterile field on a bedside table and the stretcher where the patient is lying is not condusive to appropriate patient arm position for a PICC. The most common type of room that is referred to as a "clean" room is one where there is laminar air flow into and out of the room. These types of rooms are found in the OR and pharmacy where sterile IV fluids and meds are prepared in a laminar airflow workbench. There are strict criteria for these clean rooms but these are not found in the ED or patient rooms. 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
We place PICCs in the ER, in fact I love it when they call because that patient is getting the right line at the beginning of their stay with us. We do have some rooms that are good for procedures and I use an overbed table or a mayo stand with a pillow on it for arm positioning. The lighting is generally better than our patient rooms, there is less furniture to re-arrange, help is easier to round up for timeouts etc., and - bonus - if the patient is attended in the ER it seems to help them cope with the stress. (I hope that makes sense)