Submitted by Virg, Vascular Access RN, University of Michigan on Thu Jul 8 01:20:04 2010
Looking to find out what other picc teams do: We are currently working on a position paper for our vascular access team that involves how we handle lines with associated clot formations. We know that the majority of clot formations are non symptomatic, we also realize that the new recommendations based on 2008 ACCP physician guidelines as well as ava recommendations to leave lines in place, treat and reultrasound whenever possible, also incorporating treatment with LMWH or heparin. However, there are times when physicians would like the picc lines pulled. We have consulted with a vascular physician in our facility and we currently will pull the line once heparin or low molecular wt heparin (lovenox) is initiated prior to pulling of the picc line. The issue is that there are nurses in our department are not comfortable with pulling these lines. I am of the mindset that we are in a hospital, have access to physicians and emergency equipment, and are the ones who are the caregivers of these lines and we should also be responsible for pulling the lines when this is ordered by the MD. There are others who are afraid and feel that they would be held accountable should the patient throw a pulmonary embolism and insisist that the MD should pull the line.
I would like to know what other picc teams do and do the nurses on these teams have issue with this? Any information/feedback would be greatly appreicated.