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cardiac monitoring during PICC insertion

I was having a discussion with myself about cardiac monitoring during PICC placement.  If cardiac arrythmia is a risk, do we not need to be able to identify any arrythmia during insertion?  Just curious.


Arrhythmia is possible if the

Arrhythmia is possible if the catheter and/or wire passes the SA node. This is managed by withdrawing the catheter or wire into the SVC/RA junction. I have never seen published studies of life threatening arrhythemias during this procedure. I have seen PICCs advanced inadvertently into the right ventricle without any effect on the patient. My thinking is that the cost of monitoring during the procedure could be justified if there were serious negative outcomes but I don't think that is the case. So the time, resources, and cost are not justified at this time. Of course, if I have missed something in the literature, please let me know. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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