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jaheard
Two PICCs in one arm

PICC line was placed less than 1 week ago in the patient's right basilic vein.  MD order states to place new PICC and remove old one.  Patient has had a stroke to the left side with left sided paralysis.  Is it appropriate to place two PICC lines in one arm temporarily until placement of new line is verified and then old line removed? 

lynncrni
First, why does the

First, why does the physician want the first PICC removed? The reason would have to be a valid one and suspicion of infection with fever only is not enough reason. So invesstigate that first. If the reason was valid, I would insert the new one using either the brachial or cephalic vein, staying away from the basilic on the right. You can not use the left side at all due to the paralysis. Then pull the first PICC and get the chest xray. But there would have to be a great reason for doing this!! Lynn

 

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

www.hadawayassociates.com

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

karrenberg
Why can't a PICC line be

Why can't a PICC line be placed in an arm with paralysis? What if the patient is a quad?

lynncrni
Paralysis means that the

Paralysis means that the muscle pump or venous pump action is gone. This is the normal mechanism that moves blood back to the heart. Muscles contract, upper venous valves open, distal valves close and blood is propelled back to the heart. With paralysis this mechanism is gone. Add a catheter of any kind to a paralyzed extremity and you have a wonderful site for vein thrombosis. So for a quad, I would never choose a PICC. Lynn

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

www.hadawayassociates.com

Lynn Hadaway, M.Ed., 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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