Forum topic

We have recently had increasing requests for 2.6 dual lumen PICC lines on cardiac patients and our physicians want them in the lower extremities.  We have been using the popliteal vein with ultrasound being the knee, after meauring the vein to make sure we stay between 30 to 50%, and inserting the PICC lines with no difficulties.  We are worried about mechanical phlebitis from the movement of the knee joint.  Does anyone know if it is ok or if there is any guidelines to use the popliteal vein above the knee flexion area?  Is anybody doing this?  Also, is it okay or is anybody using the greater saphenous above the knee on these patients?  Also, how long are people leaving their right atrial lines in after cardiac surgery?  Is anybody leaving the right atrial lines in longer than 1 week?  Also, in general, are people placing the PICC lines before or after the cardiac surgeries?  I think part of our issue is that we are attempting to place these PICC lines after cardiac surgeries when the patients, who usually have poor vasculature, have even worse circulation temporarily?  Any thoughts???  Please HELP!!!