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We had an end stage cancer patient (lungs, brain, you name
it) with a PICC that had experienced several days of vomiting. A few days
later he developed swelling in the upper portion of the arm that the PICC was
in, and also in his neck and face. A chest film revealed the end of the
PICC looped in the IJ. Doppler studies also revealed thrombus that
extended from the IJ, all the way back to the PICC insertion site. Very
bizarre, because his coags were fairly normal. He was placed on Lovenox
with a plan to remove the PICC after a couple of days, but he passed away the
next day. From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Scott Gilbert Sent: Wednesday, November 02, 2005 9:27 PM To: [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: Flipping PICC Loops 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?
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