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Jamie Sharp
PICC tip placement
I have a Doctor who wants to read a really good study on why PICC tips shouldn't be in the subclavian.  I had a MD pull back a line to the subclavian, and when I explained we place them distal SVC, he asked for the study showing why?  Please help! I know there are studies out there, I just can't go through every magazine right now  Thanks!
Gwen Irwin
Dierks, M and E Whitman,

Dierks, M and E Whitman, Catheter tip position in the analysis of central venous access devises outcomes. Journal of Vascular Access Devises, 1995. 1(3): p 11-14

I hope I pasted the right one.  This one looked at outcomes related to midline, midclavicular, and SVC placed lines.

Also, the position paper (referneced below) is a great one.


Chris Cavanaugh
You can also show him the

You can also show him the manufacturer's instructions for use, the FDA guidelines, the CDC and KDOQI guidelines. 

In addition, the article that was in JAVA regarding the $7.1 million lawsuit in Florida is another article that clarifies the risks.  I think it was Sept 2007

Chris Cavanaugh, RN, BSN, CRNI, VA-BC

Oncology Ambula...
In the Spring 2008 JAVA
In the Spring 2008 JAVA there is an article by Peter Verhey which talks about specific PICC tip placement anatomically at the cava-atrial junction.  There is also a reference to an article by Vesely published in Journal of Vascular & Interventional Radiology 2003, our CVIR chief uses this as a reference for PICC tip placement. Hope these help! Karen

Karen McKeon Williford RN, CRNI

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