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pulling PICC lines due to fever

Hi to all

At the hospital where I work, PICC lines have been being pulled if the patient has an elevated temp.  Which is OK with me, BUT, then they turn around an order another PICC to be placed. (sometimes the same day!).  This doesnt make sense to me.  I would like to have a protocol to determine when and if a PICC should be pulled.  Lynn, you told me that if a line is suspected of causing the temp., then a blood culture should grow 2 hours before the peripheral or grow 5 times greater colonies than the peripheral. Could anyone help me get the facts?



Fever alone is **never** a

Fever alone is **never** a valid reason to remove a CVC in a stable patient. There are 2 different lab techniques for setting up blood cultures - colony counts and time to positivity. You can read all the details in this set of practice guidelines originally written by well-known infectious disease physicians and published in 2 medical journals. It was then republished in JIN. This is the document you need for the facts you seek:

1.    Mermel L, Farr B, Sherertz R, et al. Guidelines for the management of intravascular catheter-related infections. Journal of Infusion Nursing. 2001;24(3):180-205.

If you infectious disease physicians do not know the names of the physician-authors on this paper, they must have had their heads stuck in the sand for many years! This should be the supporting evidence you need. Lynn 

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Kathy Kokotis Bard Access

Kathy Kokotis

Bard Access Systems

Because they can pull it the doctors that is. 

Rarely is it an infection suggests not pulling a line for fever but is it not easier to pull the line and than look for the cause if you are the doctor?

Kathy Kokotis

Bard Access Systems

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