We did not put any parameters in our policies on purpose.
We have placed PICCs in people with an INR of 9+ without any problem and
platelets as low as 1. We have never refused a line placement based on lab
values. A PICC is much less risk than a subclavian or jugular. I have had more
bleeding on patients with a normal INR than those that are elevated. It is just
nice to be aware that there is more potential for bleeding and we usually place
a surgicel over the site with a folded 2x2 on top covered with the opsite
dressing.
Kathleen Witt, RN
Nutrition Support
Presbyterian Hospital of
Dallas
214-345-7468
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of julie bryant
Sent: Tuesday, March 28, 2006 9:45 AM
To: [EMAIL PROTECTED]
Subject: lab values
Does anyone out there have anything in their policies
regarding perimiders of INR, PT,PTT for PICC/Midline placement. Our IR
dept. does.
Had a patient the other day with INR of 10. We refused to place the line.
Feel sort of guilty, but didn't feel comfortable placing PICC. For
time being tried to buy time with PIV, that probably won't last, will follow up
on patient after INR comes down.
Thanks,
Julie
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