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How much out is too much?

Is there any literature that speaks to how much catheter (PICC) is acceptable to leave out of the skin? Without thinking about CHG sponged, securement devices or dressing...just the catheter. I know this varies based on institutional policy, 1cm -5cm. I'm just trying to get an idea of what others are doing. Thank you in advance!

I have never seen any

I have never seen any literature on that issue. When thinking about this issue, you cannot dismiss the length of catheter needed to apply the chosen method of stabilization and the CHG dressing. That may require 2-3 cm of catheter length to add those 2 devices. So are you asking about length additional to this length? If so, the more you have out the more chance of loss of dressing integrity. The exact puncture site could alter this length also. If your entrance was too close to the bend of the arm at the elbow, you might need additional length to curl the external catheter upward away from the bend. Or some will use a short SC tunnel, eg to move exit site away from other areas of concern such as too close to the wet skin of axilla. This is a patient  specific decision. 

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Thank you Lynn - I wasn’t

Thank you Lynn - I wasn’t sure if I was missing something in the literature. I agree, this is a clinical decision and based on several factors. Yes, I was asking about the additional length or the length in general. I understand the amount left out will be based on the application of varies dressings and/or securement devices and even the insertion site location. I do agree, the more catheter outside the skin could decrease the dressing's integrity which can create other concerns such as the obvious increased risk of infection, not to mention the possibility of catheter dislodgement even before and upon dressing chances. Much appreciated!

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