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Picc tip insertion with ecg guide and arm position

Read a recent study saying the picc tip migrated towards the heart when picc placed in arm in adduction initiall, then moves from abduction to adduction after insertion. 
this doesn't make sense to me.

I've copied the conclusion 

the study is from the IV Team website: CONCLUSION: Peripherally inserted central catheter moves toward the heart when the arm position changes from abduction to adduction. Peripherally inserted central catheter tip placement at the peak P wave with patient’s arm in adduction is accurate and can prevent the catheter from advancing too low. R wave can function as a reference for observing P wave changes during peripherally inserted central catheter placement.

It seems counterintuitive,

It seems counterintuitive, but it is true. 

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Pic tip

Thank you

but I still want to know how?

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