Okay, everyone, here's a question for you. How high on the arm is too high for a PICC insertion? (Anyone ever parted arm pit hair to get in?)
I can't find INS standards for this. What are your oponions?
My thoughts are if hair will be under the dressing, then that is too high up the arm. Too much more bacteria and risks related to that area.
I agree with Gwen. If you have to shave the armpit to get a picc in you are better off in the neck. I will say we occasionally insert fairly high up, within a couple of inches of the hairline, but that is for short term ICU access and not long term therapy.
That would be a good study, comparing the bacterial counts of the upper arm approaching the axilla with that of the neck.
Darilyn Cole, RN, CRNI, VA-BC
PICC Team Mercy General Hospital Sacramento, CA
Dont really like sticking up in the "deodorant zone", and would wonder about infection risk...I've done it but never have felt comfortable with it and believe me, it is last resort.
Angela Williams RN BSN CRNI
Clark Memorial Hospital
As a caretaker of the lines in the armpit, I do not like it. Our picc team goes high up and many times I don't think there is a need to, but if there simply is not vein in a suitable area for a picc, then the patient is not a picc candidate, find another option. Beth Ferguson
I totally agree - the axilla is **not** an acceptable insertion site for any catheter due to the arm movement and the greater numbers and types of skin organisms in this wet skin area. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Office Phone 770-358-7861