As a retired PICC nurse, I was asked to provide a solution for short term frequent blood draws to a drug research clientele. All the clients have a history of at least 25 years of IVDU with a lot of scar tissue along both arms (it can be seen on U/S) however, they do seem to have a somewhat decent Brachial vein, though as seen on U/S, most have interruption of that vein as you go along the arm, with the best uninterrupted view about 10-15 cm above the AC . The RNs who work on that ward do not use U/S and have been having a very hard time accessing veins. So far the investigating MD have been inserting IJ CVC in those patients, they asked me if there is a better option.
The blood draws schedule is for 24 hours with each draw requiring at least two blood tubes. After the subject swallows the investigated medications, initially the draws are q 15 min x 2 then q30 minutes x 2, then q1 hour x 2 then q2 hours x 2 and so on for a total of about 14 times.
I thought that a PICC would be wrong for 24 hours dwell when I consider the risks vs. benefits.
I had inserted a PIV using BD 20g. w/length of 1.88 inches but it worked only 75% of the time for the entire 24 hours. The problem was when the PIV did not give blood back within a 10 min window of the scheduled draw, the study had to be thrown out.
Does anyone have any ideas of a catheter that will work with minimum risks? Am I wrong to think that a PICC for 24 hours of blood draws is over the top? Should the investigators go back for IJ? Any helpful suggestions are welcome.