bleeding from PICC insertion site

What experiences do others have with with products/procedures to deal with excessive/ongoing bleeding from PICC site?

I can see not nicking the skin in the patient with thin friable skin, and a fairly superficial vessel, but I cannot imagine trying this technique when placing in patients with healthy or tough thick skin and/or a deeper vessel.  At times the resistance offered by the skin and subcutaneous tissue is significant.  How do those of you who don't do skin nicks handle these situations?  I've tried spiraling, etc, but sometimes there is just too much resistance to proceed without the nick.  Ideas?

Hallene E Utter, RN, BSN Intravenous Care, INC

Is it similar to Surgicel?  I've used that with success.

 There is a device called Safeguard by Datascope you can use to stop persistent bleeding. It is expensive, but the IR docs use it very effectively for femoral punctures. It is available in 12cm (for normal sized arms) and 25cm sizes (for femoral punctures and morbidly obese patients). Hope this helps.

Dianne Sim RN

CEO & President,

IV Assist, Inc

Dianne Sim RN, VA-BC, CEO; IV Assist, Inc.

The Arrow MSt kits virtually eliminate the need to make a skin nick even when we place the huge reverse tapered power piccs.  My past experience of making a skin nick led to many situations where the bleeding was just more trouble that the skin nick was worth.





    I placed a picc a couple of weeks ago that just kept pouring blood.  I mean literally pouring puddles.  We tried everything to stop the bleeding dressing wise.  We sent the patient down to vascular for them to cauderize the insertion site, and the doc doing the procedure found that I had inadvertently nicked a very superficial artery while doing my skin nick, and it would not clot, despite the fact that the mans labs were fine.  We ended up taking the picc out since it just would not stop bleeding.  It was a mess!  Just an experience to share!

Be careful when putting reverse taper catheters into veins, make sure the vessel is large enough to accommodate the taper size and still leave some blood flow in the vessel.  It's not worth a thrombus at the entry site of the vein.

Are you using PICC lines that have the reverse taper feature? Since I started to use this type of catheter, the bleeding post insertion is greatly reduced as long as you can advance the catheter a few cm's from the hub.

I have found that not making a skin nick greatly reduces any excess bleeding from the site. We also place the BioPatch after insertion and this seems to soak any oozing or bleeding that we might have.


had tried gelfoam if bleeding not stop after pressure for 10min.