I am questioningÂ the placement of a peripheral IV below a PICC and am looking for others input.
A patient came into the ECC with a 4 FR. Groshong PICC that we had placed 6 weeks ago for abx. therapy.Â The patient has one arm that can be used for IV therapy and the physician ordered a CT of the chest with contrast.Â The IV nurse placed a #22 protective plus (short peripheral catheter) in the antecubital basilic vein.Â The PICC was located in the basilic vein superior to this short catheter by about 4 1/2".Â The patient received the contrast by power injection.Â The next day when I was checking the PICC I found the short peripheral catheter, removed it and then the discussion ensued.Â There was no objective findings to indicate that an extravasation had occurred.
As a side note, the nurse did not relay her findings regarding the only available vein and potential for extravasation from the PICC insertion site to the physician because she felt due to the length of time the PICC had been in place it would have created a seal around it.