I have placed PICC's on patients with pacemakers and defibrilators.  I never 
place on the same side.  If I can't use the opposite side they go to radiology 
for placement under fluroscopy.

Carol Bess, RN, BSN, CRNI
Infusion Nurse Specialist
Bellin Hospital
Tel (920) 433-3416
Pager (920) 556-4210
e-mail: [EMAIL PROTECTED]


>>> <[EMAIL PROTECTED]> 11/21/05 12:25 PM >>>

As Lynn states, patient assessment is necessary. I recently evaluated what I 
was told was a left arm insertion PICC. 
Patient had bulge near clavicle - which she told me was her pacemaker... Seems 
the radiologist  inserter could not pass the line past the pacemaker/ patient 
would not let them try again....  bit was left as a mid line. the only noted 
problem was that
Vanco was being infused via this line... She did complete therapy with no 
adverse outcome.

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of Lynn Hadaway
Sent: Monday, November 21, 2005 10:02 AM
To: Cofield Louise; Venous (E-mail)
Subject: Re: contraindications for PICC


Maybe a relative contraindication but not absolute. I would need to do a 
complete patient assessment. If the patient needs vascular access, your choices 
are PICC, tunneled or implanted ports. They all have tip locations in the SVC 
which are the same veins used for these cardiac devices. Placement of a 
catheter depends on the age of these devices. If they are firmly implanted and 
healed (usually more than 6 months), there is virtually no chance that catheter 
insertion will damage the leads. There can be vein thrombus that develops as a 
bridge between the catheter and the leads. Thus catheter removal could fracture 
the leads.  If any resistance is encountered upon removal, I would stop and get 
a dye study to determine the problem. Lynn

At 11:51 AM -0500 11/21/05, Cofield Louise wrote:

Would it be contraindicated to place a picc line in a patient that has an 
internal pacemaker and an internal defibrillator?

 Louise P. Cofield RN BSN , CMSRN
St. Francis Hospital
Clinical Educator Med/Surg
Ext 6166 Pager# 390-1167




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Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com 
office 770-358-7861









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