If a patient has a hand infection and only that arm to use is PICC placement in the same arm thought to be appropiate given the situation? I am interested in hearing peoples thoughts.
This would be based on your complete assessment and your judgment about risk vs benefits. Obviously this is not the best situation but sometimes you will be forced to make decisions that are less than ideal. What type of infection- skin, soft tissue, bone? What is the extent of tissue involvement? Any debridements or other surgical procedures? How long has this infection been treated? If there is absolutely no way to use the opposite arm, use of the arm with a hand infection for a PICC may be the best option. Are you certain that a CVAD of some type is needed?
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Office Phone 770-358-7861
It's a hard call. If it is an extensive infection in the hand--bone involvement, swelling, poor circulation I may consider discussing a tunnel PICC with the provider on the opposite side. With the inflammation and immune response in the arm area, i would think there could be an increase risk for DVT formation, or increasing the inflammation up the arm within the vessels. just a thought.