I agree with all of you.  There are some PICC's that are coming out on the 
market that no longer have the reverse taper.  They are a true 5 fr all the way 
to the hub AND power injectable.  I am trying to determine if it makes a real 
difference.....or not.  As far as the 5 and 6 fr PICC's......  I also agree.  
The patient must have the vein to support the catheter.  We do vein assessments 
prior to placing all PICC's.  If they don't have a large enough vein, they 
simply can't get a triple lumen PICC.  Ultimately, we should try to place the 
smallest catheter with the least number of lumens.  However, someone that is 
critically ill will more than likely be on many different incompatable IV drips.


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