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PICCs
 
 

Incorrect PICC Placement

 
 
 
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Jugular Placement

  • Look For

  • Placement of the PICC line in the jugular vein on chest xray.
  • Prevention

  • Ask the patient to abduct their arm and put their chin on the ipsilateral shoulder when inserting the PICC.
  • Management

  • Remove the PICC.

Subclavian Placement

  • Look For

  • Placement of the PICC in the subclavian vein on chest x-ray.
  • Prevention

  • Properly measure the intended PICC line insertion length by measuring from the sternal angle to the sternal notch and then down the arm to the insertion site.
  • Management

  • Remove the PICC.

Right Atrial Placement

  • Look For

  • Placement of the PICC in the right atrium or beyond.
  • Prevention

  • Properly measure the intended PICC line insertion length by measuring from the sternal angle to the sternal notch and then down the arm to the insertion site.
  • Management

  • Under sterile conditions, withdraw the PICC into the superior vena cava as measured on chest x-ray, and then refasten the line.
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