I would have pulled it and asked for the surgeon to put in an IJ or
subclavian line.  Too many complications.  Sounds like a site
infection and possibly a thrombus.

Is this upper arm or antecubital?  Which vein?

Let us know what happened . . .

Cindy Schrum

On 5/3/06, [EMAIL PROTECTED] <[EMAIL PROTECTED]> wrote:

Hi all
Please let me know what you would have done in this situation:

Patient 80+ years, PICC inserted to L. Basilic 4 days ago
Cannot use R arm due to mastectomy in the 1960's; needs PICC for cardiac
meds, antibiotics, and poor venous access.

Presents with clotted catheter, quarter sized area of redness, tenderness,
heat at insertion site + red, warm inner aspect of elbow. In addition, arm
below insertion site is diffusely red and edematous (arm circumference
measurements on PICC side > than other arm with lymphedema above and below
PICC insertion site). Petechiae on ventral side of all 4 fingers, not there
yesterday
No phlebitis up the vein, no symptoms above the catheter insertion site

Radiologist didn't want to do a venogram, even if the line was declotted
first (Don't know if that is because the Dept. had no capability to do it
???? or if they just wanted to go home).

Thanks
Nina E.




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