Surgeon asked for PICC placement in a 24 yo maleÂ with severe "road rash" across upper back and back of both arms bilaterally. During initial assessment in ED pt had elevated liver enzymes, low albumin, admitted daily alcohol useÂ and urine screen positive for opiates with no history of opiate prescription.Â Â Labs at time of PICC eval, 18 hrs post injury, show normal CBC andÂ kidney function, liver enzymes improved but still elevated and albuminÂ sl improved.Â Progress note states PICC requested for out-patient administration of IV narcotic prior to BID dressing changes. Pt on IV Ancef but no plan for long term antibiotics at this time. Pt has adequate peripheral veins at present and discharge is in the next few days.
PICC team felt it might be more appropriate to administer PO or IM pain med 30 min prior to dressing change rather than place central line in this patient.