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Indications for pediatric PICC insertion

Does anyone know of a reference or standard of practics for indications for PICCs in pediatrics?  Had a 5 year old with a ruptured appy, needing 10 to 14 days of IV antibiotics.   Her PIV infiltrated, 4 attempts and for another PIV.  Surgeon ordered PICC, anesthesia balked at sedation--so no PICC. I need research backup before I discuss this with the anesthesia staff. Thanks

Angela Lee
The indications for PICC

The indications for PICC placement in pediatrics is pretty much the same as for adults.  This includes extreme phs or osmolarity, infection, length of tx,  need for TPN and many other diagnoses and conditions.  In the download section there are early assessment forms that can be used as guides.

We place PICCs in ruptured appys as a matter of routine.  I would most definitely consider this an indication.  A five year old can do well with PICC placement at the bedside using local anesthetic, however, once they have been traumatized with multiple PIV attempts their ability to cooperate decreases significantly.  Other options for sedation might include po versed or ativan.  If you have child life services they can be helpful.

Therare several reasons why this diagnosis is an indication for PICC placement and you can likely find all of them on the forms mentioned previously. 

Anne Marie Frey
Try article:  Stovroff,

Try article:  Stovroff, TKotten, and Glick.  PICC lines save money and hasten discharge in children with ruptured appendicitis. J. Peds Surg 29 (2) 242-7, 1994.                      Anne Marie Frey RN, BSN, CRNI

Clinical Nurse Level Four

Vascular Access Service: I.V. Team

The Children's Hospital of Philadelphia

Anne Marie Frey RN, BSN, CRNI, VA-BC Clinical Expert Vascular Access Service: I.V. Team The Children's Hospital of Philadelphia [email protected]

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