Difficult Peripherally Inserted Central Catheter (PICC) Insertions

The “Interesting Cases” column is now linked to E-VAN, the bimonthly electronic newsletter from the Association for Vascular Access. For discussion about this column though E-VAN, please send your opinions, questions, and rationale to interestingcases@avainfo.org.

Nadine Nakazawa, RN, BS, OCN, is the PICC Program Coordinator at Stanford Hospital and Clinics, Stanford, California. She has been inserting PICCs for over 15 years and using ultrasound for 4-1/2 years. The above discussion is her own opinion. She invites you to discuss these scenarios with your colleagues to see what their opinions and decisions might be. There may not be one right answer. The important point is to have the PICC nurses develop critical thinking skills with insertion related issues.