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PICC Arm Circumference

Hi everyone,

Any help will be appreciated.

I am working on standing orders for PICC Line use.  I included daily arm circumference checks in the routine care section, but have been told that our institution no longer performs these.  I am wondering what other institutions are doing with regard to this.

I use the MST with ultrasound for placement and routinely check and document arm circumference post insertion.

Thank you in advance for your input.


Hi, Jwhitley - many of us no

Hi, Jwhitley - many of us no longer do daily mid arm-circumference measurements.  Do a search on this forum, and I believe you'll find helpful information.

Mari Cordes, BS RN 

Nurse Educator IV Therapy
Fletcher Allen Health Care, Burlington VT
Educator, Bard Access Systems 

Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center

There is no published

There is no published evidence that frequent (e.g., daily or weekly, etc) midarm circumference measurement makes any difference in the outcome with the catheter. Therefore, the 2006 edition of the Infusion Nursing Standards of Practice state that a baseline measurement is needed along with measurement when there are signs and symptoms indicating a possible problem. 


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

Personally, I think there is

Personally, I think there is considerable value in recording the baseline measurement at insertion and using it when there is other evidence of a problem resulting in arm swelling but daily measurements seem to have less value.  There is nothing like specific comparison readings from the baseline when documenting a problem.  There are physicians who will say "leave the catheter in place" when the arm seems a "little tender and swollen" but few will argue when you have the centimeter comparison to show them.


Rich Lewis, RN

Thanks for your input, I
Thanks for your input, I really appreciate it.

Janette Whitley, RN, VA-BC, Vascular Access Specialist

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