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Lane Holloway
Selecting appropriate size PICC lines for pediaric patients

Could anyone help me determine whether or not there are any written guidelines for practitioners to use when determining the appropriate size of PICC lines that need to be placed in pediatric patients?  Is there any particular formula you can use or are there any best practice guidelines?  Does the fact that antibiotics will be administered over several weeks and the fact that labs will be drawn during that timeframe to determine blood levels play into the consideration?

Thank you,

Lane Holloway

Gwen Irwin
Generally, the fact that

Generally, the fact that antibiotics are given and lab is needed does not enter to the process of catheter size selection.  I am not aware of written guidelines about catheter size.  The pediatric PICC nurses usually base the size of the catheter on the size of the vein, the vein choice (basilic vs. cephalic), and the length required for the child.  Cephalic vein, smaller catheter.

Sometimes, the age of the patient is also considered.  Under 3, no 4 french catheter, except rare situations of needing a dual lumen for a short period of time.

Hope this helps.

Gwen Irwin

Austin, Texas

You can infuse antibiotics
You can infuse antibiotics through any size catheter. You can even draw blood samples from the small lumens with care. There are no written guidelines about the size to use for any patient. The standard is to choose the smallest size catheter capable of delivering the prescribed therapy and this planned therapy would not restrict the size to a large gauge. It all depends upon your assessment of the vein lumen size with the US. Also use this conversion - French size is millimeters of diameter X 3. So a 3 French catheter has a diameter of 1 mm. The vein diameter should be larger than this. One experienced PICC nurse uses the guideline of not wanting the catheter to consume more than 50% of the vein lumen diameter. To do these measurements you will need an US machine capable of giving you this information and then you can compare it to the catheter size. Lynn

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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