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Multiple lines in SVC

 Please share your thoughts and advice on PICC placement while there is an existing CVC in place e.g. TLC, PA cath, infusion port etc.  In a prior facility we didn't attempt routinely due to increased risks e.g. inability to pass PICC, intimal vessel damage, entanglement of lines, infection risk and thrombus.  In current facility it is attempted.

We often place a PICC with an

We often place a PICC with an existing central line in place, often so that the central line can be removed. These patients are often ICU patients on multiple drips and need the access until the PICC is placed and confirmed. We have never had an complications (that I am aware of) and rarely encounter any difficulty passing the PICC. As with pacers, we place on contralateral side whenever possible.

 The need for a second CVAD

 The need for a second CVAD is based totally on the specific circumstances of each patient. Obviously if you can avoided it, that is best. But sometimes it can not be avoided due to the patient's needs. This requires a careful assessment and proper planning by an infusion specialist. More lines means more risk. So this requires a risk-benefit analysis. 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

Here's an article on this

Here's an article on this topic..just read it recently...


Scheithauer, S., Häfner, H., Schröder, J., Koch, A., Krizanovic, V., Nowicki, K., & ... Lemmen, S. W. (2013). Simultaneous placement of multiple central lines increases central line–associated bloodstream infection rates. American Journal Of Infection Control, 41(2), 113-117. doi:10.1016/ j.ajic.2012.02.034




Results showed CLABSI rates were significantly increased when 2 more more CLs were in place simultaneously. Their findings suggests that the current method for CLABSI surveillance should be modified to account for patients with multiple lines..resulting in a more precise prediction of risks.





Kevin Arnold RN, MSN

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