I am wondering if placing a PICC on the same side of an established tunneled catheter is a bad idea? I have placed a catheter on the same side as a central line (out of absolute necessity) and when it was pulled, the PICC line was displaced. I was wondering if the same could happen to a tunneled catheter if a same-side PICC was pulled? I would hate to displace a longer-term line. That being said, when I look at pictures of tunneled catheters, they usually enter into the IJ and look pretty thick. Not something that would be flipped up easily. That being said, there can be smaller-bore tunneled catheters or every once in a while a tunneled cath that enters the subclavian. This question also applies to ports/dialysis catheters. I know it's ideal to go contralateral but what happens when ipsilateral is the only choice? Thanks!
You can have a displaced tip with any type of CVAD when a second CVAD is inserted and removed. It is documented to happen regardless of the side of insertion for the second one, the type of CVAD, size of CVAD, or insertion site of CVAD. It is not a permanent thing as it can easily reposition itself back to the original tip location. Or you can use appropriate power flushing techniques to reposition the tip back to the original location.
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