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Denise Harper
outpatient PICC placers

For those of you who place outpatient PICCs:

Do you require a history & physical?

If so: What time frame does it have to fall within?

Who does the H & P?

What other requirements are there--npo, med list, etc.

For all PICC placers:

If you have to pull a catheter back less than 5 cm, do you re-xray?

Thanks so much for your responses.

Denise Harper, RN, CRNI

mary ann ferrannini
 We place both the
 We place both the outpatient and inpatient PICCs. We do require a current H & P that is within a 6 mo time frame. The MD ordering the line generally does the H & P,but if more than one MD is on the case,we will take that as well. We have has a lot of discussion around the pull-back issue. It really depends upon where the original tip location is and that it can be clearly seen. For example,if the tip is clearly seen 5 cm into the RA we pull it back into the low SVC. We are more concerned when we advance from the innominate or upper SVC so we do not malposition it into the azygos system. If there is any chance that your pull back can end up in an unintended location,you should re-Xray.
I always pull back after re
I always pull back after re xray.  How else do you truly confirm were the xray is? Susan
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