Forum topic

4 posts / 0 new
Last post
peripheral cathether below PICC line?
Is it ever permissible to insert an peripheral IV below a PICC (in the lower arm area) if the PICC is not working..and pt needs immediate IV access?  Any input would be appreciated. Thanks
Robbin George
We just had an incident
We just had an incident around this very issue--The OR did not use the PICC in surgery and elected to place a PIV below the PICC--A major infiltration occurred into the upper arm and the PICC had to be removed--Of course the problem is not so much about where the PIV was placed but that site observation was not vigilant enough to catch the incident before it became a major issue for this patient 

Robbin George RN VA-BC

Diane C Lauer
I am wondering if this was

I am wondering if this was caused by an infiltration of the PIV? 

Celia Brown

A PIV distal to a PICC site

A PIV distal to a PICC site is always the last resort. Was the PICC placed in the basilic vein? Was the PIV on the basilic side or more likely in the cephalic vein? If the PIV was placed on the ulnar side of the arm, there is a great chance that it was infusing through the same vein where the PICC was located. Also, why was the PICC not working? If there is thrombosis in the vein around the PICC, and the PIV is on the ulnar side of the lower forearm, then infiltration at the PIV site is entirely possible. The reason is obstruction of fluid flow upstream leading to overflow of the fluid at the PIV puncture site. This is a well known cause of infiltration/extravasation injury. How long had the PICC been in place? Was there enough time for the puncture site to heal sufficiently? If not there could be some leakage from that site as well. 

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

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

Log in or register to post comments