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csherriff
Starting PIV in an arm where PICC has been discontinued

I am looking for evidence to support a policy on when a PIV can be initiated in a patients arm that has had a PICC discontinued from it.  

I have done a literature search (including the Journal of Infusion Nursing) and have contacted the manufacturer of the PICC lines that we use and have not found any recommendations regarding wait times.

 We place all of our PICC lines in the upper arm, so any PIV starts would be below (distal) to the PICC removal site.  We are concerned about potential extravasation or infiltration of IV medications.

 Thank you for any assistance you can provide.

Colleen

lynncrni
Look at the anatomy and

Look at the anatomy and physiology chapter in the textbook, Infuison Therapy in Clinical Practice. There is a diagram of wound healing. I asked this question about any venipuncture and the time interval when it would be safe to make another venipuncture distal to the original. I could not find any studies addressing this with any catheter and certainly nothing about PICCs. So I turned to the standard anatomy literature on wound healing. Complete wound healing through the 3 stages, inflammation, proliferation, and remodeling - takes about 100 days, but is impacted by disease and nutritional status. If you apply this information to the process of healing the puncture site, it would be safest to wait this length of time. I do not know that this is necessary based on scientific evidence however. 

 

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

www.hadawayassociates.com

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

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