Re: INR and PICC insertion

[InfusionTx]

There is not national standard that "requires" an INR to be checked prior to PICC insertion. Some institutions have put policies in place restricting PICC insertions in patients with prolonged times.   The concern is that patients with prolonged bleeding times could have an increased risk of significant hematomas or compartment syndrome. The other side to the argument is if a patient has prolonged coagulation times would it be best to stick them in the arm or through the chest or neck. It is a debate. Perhaps the need for vascular access should be reconsidered at that time.   The speaker at AVA stated he did not feel there was a need to monitor INR prior to PICC placement. He offered no specific data to support his view but then I don't think I have seen any data to support an increased incidence in hematomas or compartment syndrome with elevated INRs. It sounds good on paper but not evidence based. Perhaps someone else will be able to cite some specific studies.   But the bottom line is it is an institutional decision to place restrictions based on INRs.   Tony West, RN, CRNI Healix, Inc. Email: [EMAIL PROTECTED] or [EMAIL PROTECTED] SMS: [EMAIL PROTECTED] Cell: 214-674-4848   In a message dated 1/25/2006 6:09:17 A.M. Central Standard Time, [EMAIL PROTECTED] writes: While attending the  AVA conference in Savanah, I learned that INR is no longer required for PICC placement. Can anyone direct me to documented articles related to this subject? Nancy Sullivan RN   Do you Yahoo!? With a free 1 GB, there's more in store with Yahoo! Mail.