PICC line

[yalsaba]

dear Colleages
Can we insert a picc line in an already insrerted cannula like 1 or 2 days before. is that possible , anyone doing this.

[Omer]

PICC line insertion had to be under complete aseptic condition. Inserting a PICC over a pre-exsisting cannula will lead to intrduction of infection.Keep in mind that some units do not even keep the PIV more tha 48hrs becuase of infection.
Omer Hamud
Toronto

[hehady]

I do not recommend so if the cannula was left for sometime. On the other hand, insertion of PICC can be done through a peripheral cannula

[rehman_naveed]

Not at all. PICC line is sterile and 2 days old canula is not sterile at all. But yes we can insert PICC line thru IV canula (new one) under sterile condition. This is what we are doing currently and we donot have any problem

[abomran]

Not at all, the PICC should be done under completely aseptic procedure.
How do you make sure that the canula is still sterile????

[Stefan Johansson]

We also insert PICC lines under aseptic conditions. The area is cleaned, a new iv cannula is set and the actual PICC catheter then inserted. Finally, covered with sterile drapings.
Although many infants given PICC lines are on antibiotics (for various reasons), we do not use antibiotic prophylaxis for a PICC line itself.

[drashishjain2000]

one should look at the literature as to how many of the IV cannulas inserted for (non sepsis) indications are really infected. Before one , proposes that the cannulas are always infected. We all keep cannulas (and no antibiotics) at so many occasions. If they are so commonly infected then all babies with IV cannulas shoiuld be getting antibiotics (? prophylactic). yalsaba may have a point.

[Herbs]

I do not recommend so if the cannula was left for sometime. On the other hand, insertion of PICC can be done through a peripheral cannula

How do you insert PICC via peripheral cannula? Do you use angio catheter g#24?Can you thread the catheter in? Or do you use guidewire? If with guidewire, what size of guidewire?

I am interested to know. Please email me.

Thanks.

Herbs
HIbrahim@kfshrc.edu.sa

[Stefan Johansson]

How do you insert PICC via peripheral cannula? Do you use angio catheter g#24?Can you thread the catheter in? Or do you use guidewire? If with guidewire, what size of guidewire?.

Hi! We use a Vygon catheter, Premicath, 27G. We set a regular periph venous canula under aseptic conditions and simply insert the PICC through it. This catheter has a tiny guidewire inside, making the insertion easy. After the catheter is inserted, we pull the periph venous canula backwards, leaving the PICC in position.
Usually, we do not bandage the PICC in until an x-ray control is done (to check the position of the tip)

[Herbs]

It seems the procedure you mentioned is good for the ELBW.
We are using BARD Fr#2 PICC. The introducer is so huge for a 500 gr preemie. PICC thru a peripheral cannula will be a better idea.

Thanks for the reply Stefan.

Herbs