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Should the PICC arm be limb alerted?

We are having a discussion at our institution concerning what should be allowed in the PICC arm.  Should we have labs drawn, SC injections given or PIV inserted in the arm that has the PICC line?  I found nothing in the INS Standards.  Currently we do not allow blood pressures (not a hard one to figure out) but we have mixed thoughts on the others.  Our staff is very young and "rule" driven which seems to be taking out the critical thinking piece.  Your thoughts and input would be greatly appreciated.

Thank you

My opinion is that it is

My opinion is that it is always best to avoid using the PICC arm for any other purpose. However in certain patients this is just not possible. When there are other sites on the opposite arm, they definitely should be used. If there is some reason that the other arm can not be used, I would restrict all punctures to the lower forearm well below the PICC. A venipuncture very close to the PICC insertion site could lead to a complication that could extend into the area of the PICC. And the PICC is already a foreign object inside that vein which can pose a risk of thrombus, infection, etc. So it will always be best to avoid additional injury if possible. 

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

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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