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Tips for inserting PICC/MID to a patient with a contracted arm

Hello guys! Im back to ask another question. As the title stated. Please share you tips and tricks inserting a PICC/MID to a patient with contracted arms (very difficult to extend that arm without using force) and they are not cooperative. I tried cephalic approach however it is very rare for me to find a good cephalic vein for these type of patients. THANK YOU!

Ibraheem Y Aljediea
Ibraheem Y Aljediea's picture
Hello Jibles

Hello Jibles

In our hospital my team does a good deal of geriatric patient, contracted sometimes and here is what we do :

1-the puncture with ultrasound will be horizontal or upward if it is for the basilic vein “ need practice in using ultrasound in horizontal approach”.

2-we have no problem whatsoever with the brachial as option 2 in our practice if it is there

3- even we are avoiding the cephalic but we do as option 3 , usually no problem because its at the lateral side of the arm.

ibraheem aljediea

johns hopkins aramco healthcare

saudi arabia

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