Does anyone have any parameters for labs before inserting PICCs?. At present our policy states "pre-procedure platelet count reviewed & level is apppropriate". My co-workers & I disagree on what level is appropriate and would like for our policy to be more specific. Any help would be appreciated.
You can search this site for many previous discussions about this issue. Basically, a PICC would be considered to be the safest type of CVC in patients with all types of bleeding alterations. With a PICC insertion site, you can place manual pressure to control bleeding. This is not always possible with the subclavian site due to the presence of the clavicle. There are now several hemostatic products used to control slow bleeding from a catheter insertion site including Bioseal and Guardiva. I would not limit PICC insertions to only those patients with normal platelet counts and INRs, etc. The fact is that the patient needs some type of VAD. Avoidance of a PICC in these patients increases the risk when a subclavian or IJ CVC is used instead of a PICC. 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