We are in the process of developing a protocol for removal of picc lines with associated clot formation, as that seems to be the most common practice of the MDs in our facility. The issue is that we are not sure what clots we should be most concerned with. Our nurses have traditionally had the physician remove the picc line if there is an associated clot or thrombus formation. However, upon literature review and utilizing forums such as this, we have decided that the PICC nurse should be removing the line....the issue is...what clots (such as those that involve axillary, subclavian veins,etc) should we be concerned about...should the MDs be removing these lines? Recently we had a patient whose MD placed an SVC filter in prior to having the line removed.Â
Some of our nurses do not want to remove the lines as they are worried about PE, especially with complex thrombus formations.Â
 Does anyone have any criteria they use with related to removing these lines?
Is anyone concerned with the location and size of the clot when they remove these lines?
Any information would be greatly appreciated.