Recently a friends son was in the hospital and had a PICC placed. She wasn't happy that Radiology placed the PICC in the Cephalic vein. When her son returned to the unit, she called the nurse to check the PICC due to it not being clamped. The nurse told her that there is new evidence stating that PICC's should not be clamped due to the risk of fibrin sheath formation. WHAT!!! I have researched and have found nothing stating that. Has anybody seen this in the literature? Also, another friend told me that there is literature stating that a PICC should not be placed in the Brachial vein due to high risk of DVT. The literature that I have seen stated that the DVT rate for Brachial placement is 10% vs Basilic rate of 14% and Cephalic rate of 57%. Any thoughts on these issues? Thank you.
Warren Willard RN, VA-BC
Forum topic
Mon, 12/26/2016 - 12:47
#1
Clamp vs non-clam PICC
Clamping and fibrin is a strange concept, never seen it in literature. They may be confusing the issue with the type of needleless connector being used, blood reflux and clamping sequence. Also basilica is largest vein diameter and preferred for PICC insertion. Thrombosis is directly related to catheter to vein ratio. Cath should consume no more than 45% of vein lumen. Brachial vein has greater risk of nerve damage. 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