Re: Flipping PICC Loops

[Leigh Ann Bowe-geddes]

Scott: I saw two well placed PICCs this week that migrated to unusual positions. One flipped up just at the tip, with the end of the catheter pointing upward. This resolved with flushing and sitting the pt up. The other was in good position for three days, then migrated to the azygos. I left that hospital before the repeat x-ray came back on it, but we positioned that pt on his right side and flushed, then sat him up for a while. I expected this one to reposition also, and didn't hear that this trick didn't work. In our facility we had a pt with a PICC in lower SVC, but it kept flipping up to the IJ. He was on a high frequency vent, so we thought that may have been the reason for this problem. Leigh Ann   Leigh Ann Bowe-Geddes, RN, CRNI IV Therapy Specialist Infusion Services Department University of Louisville Hospital Louisville, KY 502-562-3530 >>> "Scott  Gilbert" <[EMAIL PROTECTED]> 11/03/05 12:26 AM >>> Just wanted to see if others have noted any situations of well placed PICCs that have looped upward at a later date.   Migration of tip has been discussed before.    What we have noted is that ventilated patients, those who get regular (hourly) bed generated back percussions, or chest compressions during Codes have tossed a PICC upward towrd the jugular.  Recently two patients (on ventilators) with PICCs within 2 days of good placement (caval atrial 5FR DL Poly)  following several thumping episodes on special bed vibrators have had PICCs loop upward (still tip pointing downward) into the IJ.  And they remained stuck upward (not falling afer 24 hours) until pulled or replaced.  On one of the patients it happened with the second PICC also !   Any similar incidents?       ----------------------------------------------------- Confidentiality Disclaimer This message, including any attachments, is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law, including PHI (Protected Health Information) covered under the Health Insurance Portability and Accountability Act (HIPAA) of 1996.  If you are not the intended recipient(s), you are notified that the dissemination, distribution, or copying of this message is strictly prohibited.  If you receive this message in error, or are not the named recipient(s), please notify the sender or contact the University of Louisville Health Care I.S. helpdesk at 502.562.3637 to report an inadvertently received message. -----------------------------------------------------