Does anyone have a policy or procedure that they can share related to inadvertent arterial puncture during PICC line placement? This is rare for us and is identified immediately when it does happen with newer team members. The procedure is terminated, pressure is held and the physician is notified. The site continues to be monitored for complications. Just looking for a specific policy to help make sure it is always handled the same way.
I am also looking for legal cases involving arterial or nerve complications related specifically to PICC procedures to share.
Thanks!
Arterial PICC placement can easily be overlooked. Most rely on seeing pulsatile blood return or a different color of the blood but that is not going to be seen in many arterial insertions. If there is ANY question about where the venipuncture was made (brachial veins are closer to brachial artery), any difficulty on venipuncture or catheter advancement, or strange location of the tip, you can either transduce the lumen for pressure or obtain a blood gas from the lumen. While I have been an expert on legal cases involving arterial PICC insertion, several nerve injury cases, and air embolism due to administration set management, those cases were all settled out of court. This means they are a private settlement and all parties must agree to keep the details totally private. The experts are never told the details of these settlements. I have never had one of these cases actually go to trial, which would be required to make it public knowledge. There are a couple of legal case databases where you might be able to find such cases, but I think there is a fee for access to those databases. 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