Forum topic

2 posts / 0 new
Last post
cmnurse
chest pressure and PICC

I placed a single-lumen groshong PICC on a patient to the left basilic on friday. No problems with placement, tip resided at the CA junction confirmed by CXR. The patient reported to me today, 4 days later, she has had constant chest pressure extending from left clavicle area along the pathway to the cavoatrial junction since placement (I had her trace the pain she was feeling on her own body). A repeat CXR today verified the tip still resided nicely at the CA junction. No left arm or shoulder pain, her arm circumfrence remains the same, no distal swelling to the insertion site.  I had no answers for her, and since she is now an outpatient receiving infusion therapy, all I could do was advise her to follow up with her primary MD. She had a cardiac work-up this year already that was negative.

I am unfamiliar with chest pressure being a side effect of a PICC. Should the line be removed? Or is this possibly all  unrelated? 

Any input would be helpful. Thanks! 

lynncrni
If this sensation began only
If this sensation began only following the PICC placement, my first impression is that it is related to the PICC. It could be thrombosis or nerve involvement. The previous cardiac workup would not be helpful. I would want to have a color ultrasound to rule out DVT and possible a catheter dye injection. A diagnostic test for nerve compression to isolate nerve compression is not possible, so you may have to remove and replace the catheter if all else is negative and the patient can not tolerate this sensation. Lynn

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Log in or register to post comments