The Intensivist at my facility has recently decided that PICCs have too great a risk of thrombus formation to be our first choice Central Line. This occured after a week in which 2 patients developed clots around their PICCs, both 6 Fr, and both multisystem failure long term patients. Overall, our thrombus rate is about 3%.
If it is true that the PICC is more problamatic than jugular CVC's we should indeed be providing the better service. The problem is that the intensivist is not good at placing lines. It would seem logical that Vascular Access nurses should evolve into the role of providing Vascular access of sorts other than PICCs. We certainly possess the skills to expand our role, and having more options would better serve our patients.
Are any of you placing jugular lines? The AVA supports IJ PICC placement, while the INS supports EJ placement, both under limited conditions and situations. What bewilders me is why we can place a PICC catheter but not a standard CVC... what really is the difference? Is anyone seeing an evolution of roles occuring?