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Upper extremity DVT PICC question

I am seeking the opinion of the forum experts and any INS standards that someone may know of on placing a PICC line in a patient with a history of upper extremity DVT or with a current diagnosis of upper extremity DVT with the possibility of placing the PICC line on the opposite side of the diagnosed DVT extremity.

Also, I am looking for a concensus of whether or not to place a PICC line on an arm (let's say it is the only one available) with a documented skin infection of some sort in the area of possible PICC insertion or a documented infected area somewhere on the arm in general. 

Thanks to all for your valuable input! 



What caused the upper

What caused the upper extremity DVT on the opposite arm? Another CVC or PICC? What are the patient's risk factors for DVT? What type of infusion therapy do they need and for how long? What veins were involved in the DVT? All of these questions must be considered before you place another CVC. You decision must be patient-specific and based on which type of catheter will present the least risk to the patient and I do not think that one answer will work for all patients.

 Regarding skin infections on the same extremity - I would say this is a contraindication for a PICC and refuse to insert a PICC in that extremity. There would be too much risk of catheter-related bloodstream infection derived from this skin infection. 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

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