I have a resident in the ICU who states that an IJ PICC should not stay in place any longer than a triple lumen CVC (4-5 days). He says the site prep and insertion technique are the same. He doesn't buy the argument that the materials are different or that the diameter of the catheter is smaller.We do not place IJ PICCs at my hospital, they must go to IR. This includes most of our renal patients at this time. I would like to bury him in literature about this practice but I can't seem to find the right articles that state in writing that IJ PICCs (not tunneled) can have a longer dwell time.
Can anybody help me?
CDC Guidelines for the Prevention of Intravasacular Catheter Related Infections states there is no optimal dwell time for ANY type of catheter, regardless of insertion site, size, design, etc. 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
What are you referring to when you say IJ PICC. A PICC line is always in the arm. If a PICC line is used in the IJ it is my understanding that it is then being used against manufacturers recommendations. Our renal patients have to be okayed by nephrology if GFR less then 30. If not okayed the a CVC is usually placed in the IJ, but the line used is not a PICC but a line designed for this application.
There are Non-tunneled long term CVCs (SL, DL, TL) They can be placed in the IJ or subclaivian vein. They are indicated for short to long-term dwell, this CVC can stay with the patient for their entire length of therapy, from ICU to Outpatient Care.
Contact your CVC manufacturer.