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Amy Graham
Swelling in forearm of PICC

I have pt with 5FR  DL Solo Power PICC in left arm, left basilic, 3cm above A.C.  Pt has swelling to forearm below the PICC site, starting below AC.  Swelling had decreased but increased this week. Positive capilary refill, good left radial pulse. no pain at all. Going for venous doppler today.  Could the problem be the PICC.  He has been on  heprain drip entire time.y     


You did not state how long

You did not state how long the PICC has been in place. There can always be some degree of edema distal to the insertion site within the first few days after insertion. The catheter now takes the space where blood was previously flowing. Collateral veins must now take up this blood flow. Edema may be noticed when this is occurring. But edema is also a classic sign of vein thrombosis. Also what is the platelet count. Has it dropped by 50% or more. This could be HIT, which is documented to be associated with upper extremity vein thrombosis when a catheter is in place. Ultrasound should reveal thrombosis if present. Lynn 


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

Amy don't you mean

Amy don't you mean 7 French PICC? If you are using a so called 5 French Bard Power PICC, then you are actually using a 7 French because of the huge taper.  We found at our hospital that the two French size reverse taper was just too much for some of our patients to tolerate.   



Occasionally this type of
Occasionally this type of edema is a positionally induced dependent edema.  Is  the patient active and mobile, or are they the kind of patient that lies curled up on the side the PICC line is on.  I've seen patients that their typical resting position is with their arm kind of down below the level of their heart, or hanging of the  side of the bed.  If y ou think it might be positional, encourage frequent position changes, and elevate the affected arm.
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