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PICC near axilla

Hi All,

I recently had two colleagues who insist that I should  place a PICC in a patient whose catheter to vein ratio was not less than 45% until I reached approxiamately 3 cm below the axilla. Their rationale  was that they would begin the access 3-4 cm below the site and for a lack of a better word "tunnel" until they accessed the vein at the appropriate catheter to vein ratio site, leaving 3-4 cm of cather sitting in the tissue. I was not  comfortable doing so as even then, the site area was too close to the warm ,moist envornment of the axilla and secondly, I do nolt think that much catheter should just dwelll in tissue. Please advise.


This is done by most VA

This is done by most VA specialist all the time. It is very common and the reason you mentioned is probably the number one reason to do it but there are others. Learn to do the subcutaneous tunneling and apply it when the most appropritate  point of entry of the vein is vastly different from the most appropriate skin exit site. 

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Thank you Lynn,

Thank you Lynn,

I have never applied this technique but will moving forward. I appreciate your feedback.


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