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Criteria for over the wire exchange of a PICC line?

Hello Everyone-  I recently exchanged a picc over a wire that had been in for 6 days.  The reason for this was that it cracked at the hub. It was 2 hours between the time it became cracked and the exchange procedure.  This line was not a repairable line.  Pt was afebrile and the site looked good.  Our intensivist are saying they would not have changed the line and usually don't unless it is only like a day old.  Remember they are referring to TLC because that is what they use.  They feel the same way about a picc.  Does anyone have any info or literature that supports when it is appropriate to change a line over a wire?  I would appreciate it.  Thanks!!

There has never been a max

There has never been a max time or time limit between catheter damage and the exchange. No studies have been done to estabilish what this time should be. Exchanges are done for problems with catheter damage. They are even done when a line is suspected of being the cause of CRBSI and they do not want to sacrifice the line until this has been confirmed. Exchanges are included in the set of guidelines from the Infections Disease Society of America. Here is that reference:

1.    Mermel LA, Allon M, Bouza E, et al. Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection: 2009 Update by the Infectious Diseases Society of America. Clinical Infectious Diseases. 2009;49(1):1-45.

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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