If a PICC is dislodged and the new radiology read confirms placement in the PROXIMAL superior cava, would that be a reason to remove the PICC and place a new one? The patient gets a daily Daptomycin push and weekly lab draws. The estimated duration of therapy is 4 total weeks
By PROXIMAL, I am assumiung you mean the cephalad end of the SVC, or upper end, fartherest away from the heart. Proximal and distal can mean different things to differnt people. Read the drug information about its characteristics - pH, osmolarity, etc. The question is how much longer does the patient have in this 4 week period. This is not a vesicant. I don't know what the prescribing information says about local infusion site reactions but you should learn that information. Do a Google search with "drug name prescribiung information" Also everyone doing infusion therapy should have access to Intravenous Medications, published annually by Elsevier, the best drug reference for IV administration. If the remaining time is close to the original 4 weeks, I would probably do an overwire exchange after assessment of all factors. If only a few days or one week left, and there is a good blood return and absence of all s/s of any complication, I would probably try to complete therapy with it. This is a judgement call after your full assessment.
Lynn Hadaway, M.Ed., RN, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861