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PICC's in HIT patient's

Can you tell me if you have a magic number you follow in your facility for the minimum platelet count that you will place a PICC line for a patient with Heparin induced thrombocytopenia. Thank you in advance. Robin

Karen Day
Karen Day's picture
we typically do not place
we typically do not place picc's in patients with platelet counts less than 20, however each patient is looked individually - I don't think you can have a magic numbe, however, obviously extemely low patients may require some intervention priot to line placement if able to obtain a PIV.   There are some patients whose platelets are chronically low (cancer pts), yet a picc is still the safest choice for a central line for them as you can control any bleeding from a peripheral site much better than anywhere else.  I would say that if your facility is still using Heparin flushes to "lock" your catheters with, I would advise caution about placing a picc line that would require this due to their HIT
It is important to remember

It is important to remember that HIT is an immunological problem, not a bleeding problem. Yes, the immune response is decreasing the platelet count, but bleeding is not the problem. Clotting is the problem. So I would not be concerned about placing a PICC in a patient known to have HIT. 

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

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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