Looking for documented proof that taking blood pressures over an existing PICC line that is indwelling is not a good idea. Common sense tells me that the mere squeezing of the tissue puts pressure on the vein and then the catheter and could cause vein irritation, possible catheter damage. Does anyone have any documted proof that I can show to non IV people explaining this? We use Bard catheters and the package insert does not address this issue.
How would a researcher ever go about providing documented proof positive that this was happening? While we need to use evidence based practice, we can not loose sight of the fact that something will never be supported by research. Evidence to support not taking a BP over a PICC is derived from anatomy and physiology information combined with our knowledge of normal venous blood flow. Read about the muscle pump or venous pump, endothelial disruption causing immediate thrombus development and then you have the basis for not doing this procedure. A&P is now a category IA/P level of evidence from the INS standards of practice. 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
Lynn--Would the same anatomical logic extend to the avoidance of placing an additional IV infusion in the same arm as a PICC?
It seems that an infiltration could lead to similar complications?
Particularly in the ICU setting Nurses want to leave in an existing PIV if they perceive a potential need.
Robbin George RN VA-BC
Robbin George RN VA-BC
In my opinion, that would depend upon where the peripheral site was in relationship to the PICC. It might not be an issue with an infiltration in the lower forearm. Again, my opinion leads me to a greater risk of endothelial disruption from causes other than compression when you have a PIV and PICC in the same extremity. A BP cuff is direct compression of the vein against the catheter. Hope this is making sense. 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