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Mats Stromberg
Should external catheter length be kept short?

Dear listers,

when placing a Groshong single lumen PICC, how long catheter do you leave on the outside? This measured as the entire length of blue catheter visible outside on the skin after the connector has been added. I will generally leave 1,5-2,5 cm. If we have to pull it too much after x-ray, we will cut it and replace the connector.

Do you agree with me that (generally, any catheter) the longer the catheter, the higher risk for it to gradually slip further out, as it is more difficult to secure the catheter properly? Also I think there is a higher risk for someone to accidentally pull it during dressing change. Do you know of any evidence on this?


Mats in Stockholm

Groshong is a little

Groshong is a little different than other catheters because you will need to repair the external hub. This means amputating the damaged external end to replace the catheter hub. This may require additional length but no other catheter is like this. The stability of all catheters depends upon the method of stabilization. A manufactured catheter stabilization device has been shown in several studies to perform superior to sutures and tape. 

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

Mats Stromberg
Lynn, this is of course


this is of course true, but I will still not leave extra catheter in the event that it might need to be repaired later. Since we went to upper arm placement (US) damage to the catheter is extremely rare. Also, most of the time we will have the catheter tip placed deep in the lower 1/3 of the cava (with or without adjustment after x-ray), so one repair consuming say 2,5 cm catheter, will still leave the tip in an OK position. My view is that the catheter still needs to be secured also between the StatLock and the insertion and that this will be more difficult with a longer catheter.

Thanks, Mats

Hi Mats, We use to place

Hi Mats,

We use to place Groshong catheters here in Norfolk, VA USA.  We found out that leaving up to 10 cm of external line is great especially for repair.  We used fluroscopy (which we prefer nowadays) to guide us as we insert this line.  Then once the Radiologist confirms its tip position (instantly), we'll leave 10 cm out for repair (break, hole).  we use a securement device to secure this line and uses extreme caution during dressing changes.  There is however a replacement for Groshong that also doesnt need heparin locking.  It is called a VAXCEL.  If you find this product available to your company, please let me know how its working for you.  Its supposed to be stronger thus not needing line repairs.  You can even perform Seldenger terchnique with this line.  Also, we find it that once secured with STATLOCK, we place a single loop between STATLOCK and insertion site.

your friendly IV guy,


Mats Stromberg
Hi Joel, really interesting!

Hi Joel,

really interesting! I'll check the Vaxcel, I do not know if it's available in Europe.

So your experience is that the Groshong requires repairs so frequently that it is wise to leave 10 cm of extra catheter out for this? Roughly, what percentage of placed Groshongs will need repair, in your experience?

Anyone else on the cautions or benefits of leaving extra catheter out?

What is the experience of Groshong breakage/holes in other instituions?


Timothy L. Creamer
Groshong PICC IFU state to

Groshong PICC IFU state to cut the catheter leaving at least 4cm to 7cm of the catheter for connector attachment (applicable to single lumen only).

A root cause analysis probably should be performed when a facility is experiencing an increasing trend of repairing Groshong catheters.

Hope this helps.

Timothy L. Creamer, RN

Clinical Specialist, Bard Access Systems

Florida Division

Timothy L. Creamer RN, CRNI

Clinical Specialist, Bard Access Systems

Florida Division

Mats, Be mindful that 10 cm


Be mindful that 10 cm is measured from insertion site to your cut off. Then once you connect the blue connector/hub (it covers approx 2 cm) which leaves you 8 cm of external catheter.  Most of the patients we place this on are pediatric to young adult.  Depends also where the insertion site is. Like you said, if placed on the upper arm (midbicep) under ultrasound guided placement, the chance of breakage/kinks/holes might be slimmer to none.


Joel B. Cruz, IV team

Norfolk, VA

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