Hello,
Two times in the past week I have had patients with ecchymosis at their insertion site and the PICC was inserted approximately 7 days ago for both patients. One is female, 84 years old, single lumen inserted by Radiology. The other is a 25 y.o. male dual lumen inserted by me. Brisk blood returns and flush without resistance to all lumens. No increase in arm diameter (though one has no baseline measurement), skin is soft, non-painful, no leaking at site, no c/o by patient but I was called because the nurse noticed the discoloration.
Should I check for thrombosis/DVT? Could this be a long fibrin tail? What else might be causing this a week later?
Thank you,
Carole
Hi Carole, We have experienced the same on occaision. I have attributed this to sequestered subcutaneus blood from the inital insertion that is now presenting itself on the skin surface. PROVIDED, all those things that you have mentioned in assessing the site & arm are proving negative. We have not found a correlation to DVTs.
Dave B
David Bruce RN
I agree with David, sounds like the most reasonable answer. 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
Was a blood pressure taken over the picc line?