Twice I have had staff wrap a freshly placed PICC line (No nicking) with coban due to bleeding. And discovered this when the pt's arm was found to be swelled up and appeared to have a thrombosis. After obtaining a negative ultra sound; good flow around PICC, and no thrombosis, realized the pt had a coban wrap placed around PICC for over 12 hours. Looking for articles or some evidence based practice to share with my Vascular Access Team. Any help on this would be appreciated.
Thank you,
Terry
The evidence about problems with all elastic roller bandages with all IV catheters is very old and limited to short peripheral catheters. But to me, it is common sense to NOT use this type of bandage on any and all IV catheters. It violates several priniciples identified in the INS SOP on Stabiliztion. It obscures the puncture site and surrounding area from being visualized. It can occlude normal blood flow. It can occlude flow of flud through the catheter. All excellent reasons to avoid use of any elastic roller bandage. Additionally, these bandages do not have a labeled indication to stop bleeding. There are many other devices and methods for this. 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
This is an article concerning non-invasive blood pressure monitoring. My thought is pressure around an arm with a picc would be contraindicated without regard for the source - bp cuff or coban.
www.aacn.org/wd/practice/docs/practicealerts/non-invasive-bp-monitoring....
Multiple reasons exist why an extremity may not be suitable for BP measurement. BP cuffs should not be used on an extremity with a deep vein thrombosis, grafts, ischemic changes, arteriovenous fistula, or arteriovenous graft.24-7 BP cuffs should not be applied over a peripherally inserted central catheter (PICC) or midline catheter site but may be placed distally to the insertion site.25 BP measurements should not be taken in extremities with peripheral IV while an infusion is running26 or any trauma/incision. For patients who have had a mastectomy or lumpectomy, do not use the involved arm(s) for BPs if there is lymphedema.13,29
You might follow up on reference 25, it could have the info you're looking to find.