Forum topic

5 posts / 0 new
Last post
lynnemr
PICC Removal
When removing a PICC  if you run into resistance, is it still appropriate to place tension on the catheter, redress with sterile dressing and wait 4 hours then retry removing ?
lynncrni
Although some recommended

Although some recommended traction, this has never been the best way to manage a stuck PICC. The reason is the tunica media or the layer of smooth muscle inside the vein wall. It requires very little stimulation to cause contraction and can hold that contraction for very long periods with very little energy. So traction makes the problem worse -always has. So simple tape without traction, put a dressing on it, apply heat, have patient drink warm liquids and wait. A tincture of time is probably all that is needed. But never use traction!! Lynn 

 

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

www.hadawayassociates.com

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

ncosta
As Lynn reports, a tincture
As Lynn reports, a tincture of time is always best, and it's usually a matter of waiting out the venospasm.  Sometimes a PICC is stuck by the fibrin sheath and you can actually feel a lump where it has "accordianed" under the skin. We have had success freeing PICCs stuck with fibrin by instilling a dose of TPA.  This is an off-label application, of course.  Hope this helps.  Nancy Costa
Cindy Kahnk
Hi Lynn- from Omaha NE, I

Hi Lynn- from Omaha NE,

I always cringe to think of where the fibrin sheath goes with the withdrawal of a central line?    Does it stay attached to the vein wall?  Does is float off and lodge somewhere?   I have not been able to find the answer. 

Thanks,

Cindy Kahnk 

 

 

lynncrni
The fibrin sheath is

The fibrin sheath is stripped off and is destroyed by the body. I have never seen any published information about the sheath causing a problem for the patient. The other issue is the presence of a complete clot on top of the fibrin sheath. A complete clot can easily become a pulmonary emboli when a catheter is removed.  

 

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

www.hadawayassociates.com

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Log in or register to post comments