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IJ and Subclavian non tunneled at discharge


I am wondering what other facilities are doing with patients who have a non-tunneled IJ or subclavian CICC at discharge who require long term antibiotics. We advocate for patients to receive a PICC (or tunneled line for patients who are not a candiate for a PICC) for long term ABX  and remove the IJ or subclavian.  Furthermore,  we do not recommend patients with non-tunneled CICCs  to leave the facility with these lines in place d/t risk for infection. The current INS SOP states there is no recommended dwell time for any VAD. Does anyone have any literature to support removing non tunneled CICC for long term treatment and placing a PICC or tunneled line?

I have never seen any

I have never seen any literature like that. usually the dressing is the challenge. A low IJ site can have the catheter angled so that the catheter is lying on the top of the shoulder and the dressing is disturbed by neck motion. I am not aware of any studies showing that the axillosubclavian or IJ sites have a greater risk of infection when the patient is in the home. I think the most important questions would be - how much longer is the therapy needed? What is most comfortable for the patient? Who will be changing the dressings? 

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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