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» LymeNet Flash » Questions and Discussion » Medical Questions » Calling Power Picc people

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Author Topic: Calling Power Picc people
lou
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Made by Cook. Purple hub.

Are you having bleeding problems at insertion site? I know of two of us that do, and wondering if this is more widespread.

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tanzi2u
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No, but it is sutured in place. Having difficulties with the blood draws though.
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sammy
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Mine is still bleeding a little but it is a Purple PowerPICC by Bard. So I guess you can't count me since mine is from a different manufacturer.

lou, I wonder if it might be more of a problem with the introducer that was used to place the PICC rather than the PICC line itself?

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lou
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I don't know what an introducer is. Am guessing it is removed after placement? If so, why would it still cause problems a month later?

What I presumed about the power picc, regardless of maker, is that it has a larger diameter tube than what I had before. And that might cause a problem. Grasping at straws here. No call back from radiologist office that did the placement.

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Babbs
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RN here, I've done lots of dressings on these. Be sure when you have your dressing change done to have the nurse put the catheter in comfortable position so it doesn't irritate the site. Tape down an extra length of the tube to your arm so there is less putting on it.

If the kit includes it, have the nurse use the antibiotic ointment on the site, under the Tegaderm. If the site is pink-red, not too bad, but if it is red and there is any kind of drainage: white, yellow, green, grey, orange, then you need to have it looked at and maybe cultured.

Yes, the introduser comes out, yes more discomfort with a larger catheter.

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Gace24
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Hi Lou,
Do you know the size catheter 4fr or 5fr should be on the side of the upper part of the catheter.

Are you on aspirin or Plavix or other meds that can cause bleeding?

Also if it is sutured in sometimes there is some "give" if the sutures are not tight. So lifting or putting weight on your arm can cause the PICC to move in and out a tiny bit (like friction) of the insertion site so bleeding occurs. (the body normally forms a scab or fibrin around the site which helps keep the PICC in place).

So if the insertion site hole is bigger then the PICC from movement it can bleed too.

Try not to lift above 5 lbs and avoid motion that will put pressure or friction on your arm (like vaccuuming or mopping the floor)

Also if you can get a biopatch put on for your next dsg change it can absorb the blood and it has an antimicrobial embedded in it (chlorhexadine).

Also if the PICC is in the crook of the arm it will be more likely to bleed just from bending your arm.

I work with a few different brands of PICCs I haven't seen that one brand or type causing bleeding over another.

I agree with Babbs trying to stabilize the site so movement won't occur.

Grace

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lou
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Thanks, Grace and Babbs for replies.

The PICC is made by Cook. Paperwork that was sent home with me says 5.0 French Polyurethane Single Lumen.

I don't see any drainage that is a wrong color yet, just red blood. Doing my own dressing changes, very experienced, can't have home health because doc out of state. Not on any meds to cause bleeding, apart from heparin flushes. Not sutured.

Am trying to use the arm less. And it has been taped and has a netting cover to hold it in place.

I am wondering if this will eventually stop. Has been a month already. Worrying the heck out of me.

Picc in upper arm, not near elbow, but maybe using the bicep can cause movement in the line, enough to cause bleeding.

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jam338
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My picc line is Groeshon (sp?) self sealing vacuum type...no heparin needed etc.

With initial installation almost a year ago I had lots of problems with irritation at site...bleeding, swelling etc. For the first several weeks they were wondering whether it could be left in at all.

What we seem to discover was that I had to EXTRA precaution care with it until my body adjusted/accepted having it in my arm. I think it was a natural rejection to foreign object in body.

So, we implemented a plan where for weeks I did not use that arm at all. No lifting of anything with it. No over extending. No reaching up or out with it. No raising that arm up even to wash my hair. Hubby had to do that for the first few weeks.

Extra attention and care was needed to observe simplest of things that could put extra pressure on it. Discovered that even rolling over in bed in the night caused problems. I tended to prop up for a second on that arm while readjusting pillow during the night. Even that little bit would make it seep blood and become inflammed. Learned that my sensitivity was to pressure of any sort on it. Thankfully as my body adjusted to it that all settled down.

Once adjusted, I now have no problems at all. I can pretty well do what I need or want with it. My limitations now are severe fatigue where I can do nothing anyway...but not related to concern about response of picc line.

Though I do use caution about not lifting or pulling/pushing using that arm very much.

I was instructed at the hospital at the time of installation to not lift more than 10 lbs with it. But, for me I could not even reach out with it. Any movement that stretched the skin on the arm would start the bleeding/irritation.

Maybe try babying it for awhile and give it time to heal in more and see if that helps settle it in.

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lou
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OK, going to try to do nothing with arm for awhile!

But I can't type very well with one hand.

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Babbs
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Note: Power PICCs, in my experience, are prone to clotting.

Be sure you flush well. If you are using Normal Saline, extra flushing will not hurt you. Most Power PICCs have you follow the saline with Heparin, 1cc.

At the first sign of difficulty flushing use enough flush (Saline) to get it going again. You may need to use a little more Heparin also as 1cc may not be enough.

If it is not working, you will need a clot buster. I always have one on hand if someone has a Power PICC.

Just ask the supplier to send one to keep on hand. It will save you a trip to ER. There are instructions in the box.

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lou
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That's odd, the people who installed this (radiologist) said it didn't need heparin flushes. That sounded hazardous to me and I am using heparin.

How would I get a clot buster? Is this something infusion companies carry? Surely it is Rx only?

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