I will be placing a PICC in a pt who just had one removed d/t possible infection; the site also looks red, but no drainage. The other arm has a healing wound contaminated with MRSA and E-Coli on the wrist. Which upper arm would be best for insertion? Use the same side the PICC was removed, using a different vein and covering the old site with a tegaderm, or use the other arm, making sure the infected wound on the wrist is well isolated? I've always avoided any extremity with an infection, no matter how distal, but am concerned about the other arm as well. I couldn't find any guidance in the 2011 Standards. Thanks,
Tami
No set of standards or guidelines will ever be able to give you the information to make such a decision. This would be a situation where you need to do a thorough assessment of the risk and benefits of each site. This would include all medical and nursing diagnoses, lab values, anticipated length of therapy, types of therapy, all risk factors, etc. Then make the choice of the site with the least risk and most potential benefit. This would also require collaboration with the physician(s). Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861