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SuzanneMetz
PICC placement with a non occlusive thrombus

Can a PICC be placed in an extremity with a diagnosis of a non occlusive thrombus?  If not, why?  I have searched for an answer for myself and my colleagues but have come up empty handed.  Thanks for any and all responses!

lynncrni
What vein(s) are involved

What vein(s) are involved with this non-occlusive thrombus? Will the planned PICC be inserted into or advanced into the veins where this thrombus is located? For instance, if the thrombus is in the basilic vein only, you could insert through the cephalic or brachial vein and never encounter this thrombus. On the other hand if this thrombus extends from basilic into axillary or sublcavian veins, you should use the other side. Also look at all factors that led to thrombus development in the first place? Was this from another PICC? What was the catheter to vein ratio? Where was exact location of tip? Did the tip migrate or was the catheter ever dislodged and infusion continued? What hypercoagulable diagnoses does the patient have? There is no concrete or absolute answer to your question. This requires a thorough patient  assessment of all factors and choose the VAD with the least risk to the patient, 

 

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

SuzanneMetz
Hi Lynn,

Hi Lynn,

Thank you for responding.  However, the question I asked, has to do with a non-occlusive thrombus and PICC placement.  I am very well versed in proper assessment and choice of VAD's for my patients.  As it stands, I do not place any VAD in either arm that has had a history of any DVT.  

Suzanne Metz

lynncrni
And I am saying this decision

And I am saying this decision is based on a thorough nursing assessment of all factors related to patient , therapy, venue, and VAD characteristics. Then it is a judgment call of which VAD offers lowest risk. That decision could be a PICC. Also my original response was based on NON-occlusive thrombus. 

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

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