PICC placement
PREOP:
- Check Cr - we prefer not to do PICC in patients with renal failure
- Rarely needs sedation
Equipment Always Necessary
- Tourniquet (penrose)
- 5Fr Power PICC *
- Micropuncture
- 2-0 nylon suture
- Green caps (2)
- Biopatch
PREP:
- POSITION: Supine
- DRAPE: Standard
- US and probe cover
- Need scout image
Stand by Equipment
- 5Fr 65cm KMP catheter
- Contrast
Dressing:
- STAT-Lock
- BIopatch
- Tegaderm
PEARLS:
- In general, the preference is the nondominant arm.
- If patient has renal failure we prefer to use tunneled central line, since it does not damage the arm veins, which later can be used for fistulas.
- DOUBLE LUMEN: tpn, chemo
- SINGLE LUMEN: abx only