Incorrect PICC Placement
January 1st, 2018
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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