I've seen this order many times.... some feel they should never place a picc in someone who has positive blood cultures, but to rather place an IV until cultures are negative and only then place the new picc.
Others feel its ok to place the picc as long as you pull the first one before installing the second one so as to prevent the tips from making contact.
If the infection was localized to only the tip.. that would make perfect sense to me.. .but if its systemic... the whole blood system is infected so I don't see the point.
Others feel its no big deal to install one while the other is present "so as to avoid a period of not having a line", and to simply pull the suspected infected picc once the new one is in place.
IN the past, I've heard its easy for bacteria to "seed" to the new picc when the new picc is introduced into an infected environment causing the life of the new picc to be short lived as it will surely become infected too.... yet other infectious disease doctors don't seem to have concern for this issue and downplay its revelancy.
Then other doctors don't worry so much about blood cultures but rather "has the patient already been on antibiotics for a few days" implying the presence of antibiotics in the blood system would prevent any possible "seeding" to the new.
Does anybody have any credible standards of practice for such situations?