[CK] PICC LINE PLACMENT. 48hours of negative culture. PREP(INR 2, NPO 4hr)

We wait 48 hrs to make sure that there is no growth.  That is what the Infectious Disease MDs have recommended.

We wait 48 hrs to make sure that there is no growth.  That is what the Infectious Disease MDs have recommended.

INR < 2.5(preferred 2.0) 

Contra indications

Positive MRSA screen – follow the MRSA policy

Platelet count below 50

Pyrexial due to infection

SVC obstruction

INR above 2.5

Lymphoedema or ANC clearance

Sensory or motor deficiency of the arm - PICC placement where there is significant sensory impairment might delay recognition of complications.

A PICC line is a Central catheter placed in the upper arm and used for long-term therapy with medications that would irritate peripheral veins over an extended time.

 1. Labs: If the patient is on anticoagulant therapy, a PT/INR and PTT will be needed prior to the procedure. If lab results are as current as the day of the procedure, orders will not be needed for a recheck

 2. Diet: If there is an indication for sedation during the procedure, the patient will need to be NPO 4hrs prior to the procedure. Otherwise, there are no restrictions. 3. Medications: Usually, routine meds are not withheld. If the patient is on anticoagulant therapy, orders will be needed for withholding these meds.

 4. If the patient is unable to give informed consent, please have the appropriate designee available to give consent, either by phone or in person. 

5. Radiologists place PICC’s by using ultrasound. Some conditions require the use of a contrast media (X-Ray dye) to visualize the vein. 


6. The catheter is usually placed in the non-dominate arm. The patients will be taught how to care for the catheter (usually by a home health nurse), and being able to use the dominant hand will make it more convenient for the patient.