![]() ![]() A PICC may be used for laboratory blood draws. A chest x-ray is required to confirm placement, unless tip locator technology (e.g., electrocardiograph) is used during insertion. Furthermore, larger gauge PICCs are associated with increased risk for venous thrombosis. More lumens equal more catheter manipulations and increased risk for bloodstream infection. A PICC is available with single, double, and triple lumens however, a PICC with the fewest number of lumens needed should be placed. As it is a central line, any infusion therapy can be administered via a PICC. This maneuver should not be utilized without an adequate blood return first. Recognize that blood present in the catheter lumen is a perfect medium for microbes to flourish. This clears the line of any blood residue and along with a "push-pause" method, reduces the buildup of fibrin and platelets. The line MUST be flushed with saline after this procedure. A "flash" or sluggish return is not acceptable and requires further assessment. Take note that aspirate consisting of blood tinged saline would not be considered sufficient. The INS defines blood return as being "the color and consistency of whole blood when aspirated" (Gorski et al.). Because a PICC lies within this large vessel, a blood return should be swift and substantial. The PICC is inserted via the cephalic, basilic, brachial, or median cubital veins in the upper arm, and threaded so the catheter tip is located in the lower segment of the superior vena cava, which is considered central placement as defined by the Infusion Nursing Society (INS) ( Gorski et al., 2016). PICC lines are typically chosen when longer lengths of intravenous therapy are needed but both PICC lines and midlines can remain in place for an indeterminable amount of time provided they are properly monitored for complications. The patient's diagnosis, the predicted span of time the line will be required for therapy, the type of infusion needed, and the cognitive and intellectual level of the patient or caregiver are all considered when deciding which type of VAD the patient will need. Peripherally inserted central catheters (PICC), which are central lines, and midline catheters, which are peripheral lines, are two types of vascular access devices (VAD) that are used frequently and are often confused with one another. Q: What is the difference between a PICC and a midline? Facing Ethical Challenges with Strength and Compassion.Establishing Yourself as a Professional and Developing Leadership Skills.Ensuring Patient & Family Centered Care.Developing Critical Thinking Skills and Fostering Clinical Judgement.Alteplase Injection for Acute Ischemic Events.Affirming Care for Patients who are LGBTQ+.Lippincott Clinical Conferences On Demand.Continuing Education Bundle for Nurse Educators.Lippincott NursingCenter’s Critical Care Insider.Lippincott NursingCenter’s Career Advisor.An Unforeseen Path from Critical Care Nurse to Editor-in-Chief of American Journal of Nursing.When Nurses Speak, People Listen: An Interview with Pat Patton.Academic/Practice Innovation: An Interview with Dr.Nurse Wellness Is Not Just About Resiliency.Creating Learning Environments to Advance Health Equity.Using Simulation to Develop Clinical Reasoning.The Nursing Shortage and Nurse/Patient Ratios. ![]()
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