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What are PICC lines?
PICC, or peripherally inserted central catheter, is a long
IV catheter that is inserted through a peripheral vein in
the arm and is threaded up to the superior vena cava. PICC
lines are used for antibiotic therapy, chemotherapy, TPN,
lab work, pain medications, blood transfusions, and hydration.
They can be used for almost any purpose you would use a central
line for. PICC lines are not recommended for machine injected
contrast solutions, as used for CT's and IVP's.
Who would benefit from a PICC placement?
PICC's are a good choice for any patient with IV therapy
for 3 days or longer. Patients with poor venous access or
a terminal patient may benefit from PICC placement even if
therapy may last less than 3 days. Patients receiving therapy
that can be irritating to peripheral veins, or that require
frequent lab draws or IV starts are also good candidates to
consider.
How long can you use a PICC?
PICC lines, like Hickmans and other central catheters, have
no maximum amount of time that they may remain indwelling.
PICC lines have the lowest rates of infection of all central
lines. PICC lines are affordable catheters that can be cost-effective
for short and long-term therapy. PICC lines are perfect for
Home Care.
When should a PICC line be considered?
PICC and other central line placement should be addressed
at or shortly after admission. Assessing the patient early
on may save the patient frequent, painful, and unnecessary
needle sticks.
What should I do if I think a patient would benefit from
a PICC or central line?
If you think a patient may be a PICC candidate, save one
arm from IV starts and lab draws. PICC placement is normally
done in the non-dominant arm, if suitable. PICC placement
should not be considered on extremities that are fractured,
or have cellulitis or phlebitis. Other contraindications may
include dialysis access, pacemaker or stroke affected extremities.
Address any concerns regarding IV access to the managing physician
early on. Early planning can make PICC insertions much easier
resulting in increased patient comfort and satisfaction. This
is especially true when peripheral access is difficult or
long-term IV access may be needed.

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Patient Prescribed Drugs
The following list indicates those drugs that, due
to pH, osmolality or chemical structure may be best
served by early placement of a PICC line:
- Amphotericin - irritant
- Bactrim - pH 10.0
- Calcium gluconate - hypertonic
- Chemotherapy vesicants - pH
- Ciprofloxacin - pH 3.3
- Cephalosporins - fluid restricted patients hypertonic
- Dilantin - pH 12.0
- Dobutamine - pH 2.5
- Dopamine - pH 2.5
- Doxycycline - pH 1.8
- Erthromycin - irritant
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- Mannitol - hypertonic/pH 4.5
- Morphine - PCA - pH 2.5
- Penicillins All - Nafcillin, Ampicillin, Oxacillin,
Timentin Methicillin - pH 10.0/Hypertonic
- Pentamidine - pH 4.09
- Phenergan - pH 4.0
- Potassium > 20 KCL - Hypertonic
- PPN/TPN - Hypertonic
- Rocephin - Irritant/Hypertonic
- Tobramycin - pH 3.0
- Vancomycin - pH 2.4
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