Can you tell me if you have a magic number you follow in your facility for the minimum platelet count that you will place a PICC line for a patient with Heparin induced thrombocytopenia. Thank you in advance. Robin
we typically do not place picc's in patients with platelet counts less than 20, however each patient is looked individually - I don't think you can have a magic numbe, however, obviously extemely low patients may require some intervention priot to line placement if able to obtain a PIV. There are some patients whose platelets are chronically low (cancer pts), yet a picc is still the safest choice for a central line for them as you can control any bleeding from a peripheral site much better than anywhere else. I would say that if your facility is still using Heparin flushes to "lock" your catheters with, I would advise caution about placing a picc line that would require this due to their HIT
It is important to remember that HIT is an immunological problem, not a bleeding problem. Yes, the immune response is decreasing the platelet count, but bleeding is not the problem. Clotting is the problem. So I would not be concerned about placing a PICC in a patient known to have HIT.
It is important to remember that HIT is an immunological problem, not a bleeding problem. Yes, the immune response is decreasing the platelet count, but bleeding is not the problem. Clotting is the problem. So I would not be concerned about placing a PICC in a patient known to have HIT.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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