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Picc tip placement in double svc on the left side

               Picc was placed in a patient from the left side and 3cg tech was used to verify tip location.  With this particular insertion, the navigation system, Sherlock, showed the picc dropping approx. mid subclavian region and changes in the p waves were noted.  So per guidelines, the picc tip was in the lower third of the svc verified by obtaining max p waves.  With a routine am cxr, the primary Rn called our picc team to inform them that the radilogist commented about a possible left side svc and the picc tip was visualized in the distal left svc. Our question is, is it considered a malpositioned picc if the patient has a double left sided svc and is it safe to leave the picc if the tip is in the left sided svc?  

It is acceptable to leave a

It is acceptable to leave a CVAD tip in a persistent left SVC, however you must have some diagnostic tests on the blood flow pathway back to the right atrium. This should be done in radiology to show that this pathway can tolerate the presence of the catheer and the fluid flow. 

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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