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kratz
Numbness in hand after PICC removal

A pt. recently had their PICC removed and reported that she felt like her hand was "on fire" when the PICC was being removed. She reported that she had numbness to 3 of her fingers on that hand after the line was removed. Over the past 2 weeks, the numbness has resolved to 2 of her fingers, but the one remains. The PICC line was in the brachial vein and I know that the nerve had to be involved with the symptons that she is stating. She did not report any of this numbness during her hospital stay,just after the PICC was removed. Has anyone had experience with this kind of situation?

kratz
Karen Ratz,RN St. Lukes
Karen Ratz,RN St. Lukes Hospital, Cedar Rapids,IA

Karen Ratz,RN St. Lukes Hospital, Cedar Rapids,IA

kratz
Karen Ratz,RN St. Lukes

Karen Ratz,RN St. Lukes Hospital, Cedar Rapids,IA

The pt. had mental status changes(septic) when the PICC was placed. She was very restless and confused. She recovered completely, but at no time during the hospitalization did she complain of any of the symptoms of nerve injury. She did not display any complications of the PICC line.

Karen Ratz,RN St. Lukes Hospital, Cedar Rapids,IA

lynncrni
You are correct about nerve

You are correct about nerve involvement. While it is odd that this only occurred upon removal, I am wondering if it is related to an increasing vein thrombus that is compressing the nearby nerves. What diagnostic tests have been done? I would at least want an ultrasound to see if there is vein thrombus present. My huge concern is that nerve damage such as this can become a lifelong chronic pain condition known as complex regional pain syndrome. Your patient may also need to be seen by a neurologist. 

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

www.hadawayassociates.com

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Gwen Irwin
My experience has been that

My experience has been that patients have some symptoms on insertion that indicate the nerve involvement.  This is very interesting that the symptoms only occurred with the removal.  We have never had this occur.

There are no comments about the patient's comments on insertion?

We did have 1 nurse that had a PICC inserted that tried to tolerate the discomfort of the nerve involvement and totally denied any sensation or discomfort at insertion.  We replaced the PICC about a week later, due to continued discomfort, and she continued therapy with the new PICC without any incident.  She also did not have any problems after the initial PICC was removed (or so she denied).

Gwen Irwin

Austin, Texas

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