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holly hess

For those placing neonatal/infant PICCs via the saphenous vein:

do you consider optimal tip placement to be just above the diaphragm, like a UVC? Some of our neonatologists are asking for below the diaphragm due to concern about the tip moving into the heart when the baby flexes its legs. I have also spoken with PICC inserters from another hospital who consider anywhere in the IVC OK. Is this addressed in INS standards?(Somebody has my copy) Thanks,


Standard 42 Catheter

Standard 42 Catheter Placement 42.4

Those central vascular access devices using the femoral approach shall have the distal tip dwelling in the thoracic inferior vena cava above the level of the diaphragm.  

This language covers all ages and was reviewed and accepted by several neonatal and pediatric IV experts. Lynn 

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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