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sg75095
Inserting PICC lines with pacemakers

I know this subject has been brought up before.  Does AVA have a stance about placing PICC lines in patients with pacemakers. We had a situation where a cardiologist was upset about placing a picc line on the same side of a pacemaker.  This was not a new pacemaker so the vascular access nurse attempted, it was malpositioned and was ultimately dc/d immediately.  This physician stated he has experienced where pacemaker wire has been dislodged due to a picc line.  The other side was not an option due to pt not having any adequate veins.  I have read the standard for site selection in the INS book, there is no reference to pacemakers.  I know our facility avoids that side if at all possible, especially if it is a new pacemaker.  If multiple doctors are seeing this patient we will always confirm with cardiology the picc order prior to placement.

Thanks

lynncrni
There is very little evidence

There is very little evidence about any CVC and pacemakers or ICDs. We have an online course on this topic , written by Deb Richardson, MSN, RN, the former Clinical Nurse Specialist from MD Anderson. Se goes through all of the available evidence and provides lots of food for thought on assessing this situation for site selection. A CVC can result in fractured pacer leads along with other complications like thrombosis. When the opposite side was not available for PICC insertion, did the inserter speak to the physician about using the ipsilateral side? This should have been a collaborative decision prior to insertion. 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

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