We have a patient who had a PICC placed to receive sedation for ECT treatments. The tip was in good position at the time of placement. She was having treatment once a week for a couple of weeks. Now it's gone to once a month. Now she is in for surgery and the question is...should we get an x-ray to check tip placement before surgery...and should they just use the PICC or start a peripheral I.V. for surgery.Â
 Has anything been written about frequency of PICC tip verification?
Thanks,
Tanya
Kristin Walker RN, BSN, OCN Maui Memorial Medical Center IV dept.
There are no written standards or guidelines about this, however there is a lot about tip migration after placement. So the best practice would be to always obtain a chest xray, especially if the catheter was placed at another facility, there are functional problems with the catheter such as no blood return, or you know there are factors that lead to migration such as coughing, vomiting, etc. Many hospitals have this policy. On the other hand, anesthesia may not want to use a PICC for their purposes anyway. I would want an xray to see where it is myself! Closest statements are INS SOP # 42, Practice Criteria M. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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