Does anyone know of specific criteria or guidelines to determine if a DVT is related to the PICC? Of course there are the obvious, however there are some that our team question if the thrombus was developing/or developed with the peripheral IVs a patient had prior to the PICC insertion to the lower or upper arm and would this be counted as a DVT against that PICC? Sometimes it is not always clear how to categorize these. For those of you that are tracking your DVT rates, what guidelines do you follow? Thanks for your feedback. [email protected]
If the PICC has been placed in the same part of the venous system as previous peripheral catheters, e.g. the basilic, then I think it is quite likely that the thrombophlebitis began with the PIV. However, I think you would need to quantify the length of vein involved with the thrombophlebitis and the exact location of it in relationship to the PICC. The vein could have been irritated without any external signs or symptoms, yet the insertion of a PICC exacerbated the situation and extended the problem. So I would maybe have a subcategory in my reporting where this may have been the case, but I think it all should be included in data collection. This would be evidence to get an earlier assessment for PICC insertion before those PIV complications develop. 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
Thanks Lynn for your valued input! :)
Cindy Hunchusky, BSN, RN, CRNI
Depending on the quality of your ultrasound, one can assess the health of the vessel. Most machines are capable of showing the obvious lack of blood flow in the vessel, but higher quality machines allow the user to assess the vein layers and their thickness. This can assist one with determining overall vessel health and thus avoidance of placement of the PICC in an already phlebotic location.
Cheryl Kelley RN BSN, VA-BC