Comments on: PICC-up Question

By: Tully

Tully — Sat, 13 Mar 2010 20:16:09 +0000

FWIW: When I was managing an IV cinic we installed about 200 PICC lines. The only infection case we had was in an AIDS patient who was already severely immuno-compromised. They made it past that — in part thanks to having that PICC line — but died from other complications of AIDS. (This was the early \’90s.)

By: William Young

William Young — Sat, 06 Mar 2010 21:57:21 +0000

Much like Mr. Sakers above, I had a PICC line for about two months (around ten years ago) for regular antibiotic treatment. Other than it taking a while to get into the habit of making sure nothing whacked the insertion point (since it really hurt to do so, but nowhere near as painful as when the line was initially installed), the only problem I had with it was a very slight infection that cropped up at the insertion point a couple of days before they removed it.

The removal had nothing to do with the infection, though; it was purely random chance. And random lucky chance at that, since it allowed the line to slide out of my arm that much more easily.

By: Kirk

Kirk — Sat, 27 Feb 2010 21:06:24 +0000

Fred’s comment about washing hands reminds me of an interview with Dr. Atul Gawande that I saw on Democracy Now! back in January. He wrote a book titled ‘The Checklist Manifesto’, in which he promotes the use of checklists in hospitals to minimize errors made in medical procedures. He got the idea from Boeing. The first flights of the B-17 ended in several crashes. The problem was that the new aircraft was much more complex than what the pilots had flown previously, and omission of one or two pre-flight procedures resulted in the crashes. Boeing came up with the idea of a checklist – a list of pre-flight details to check before takeoff, and the crashes ended. Similarly, modern medicine is so complex, that doctors cannot keep all the information in their head. Checklists for various medical procedures were tried out in a number of hospitals, and resulted in dramatic reductions in malpractice and death. ‘Wash your hands’ was a simple step on the list.

By: John Boland

John Boland — Fri, 26 Feb 2010 17:32:07 +0000

Our household’s experience with these things doesn’t point to hospital infection. In fact, the picc line
is a way of getting you out of the hospital and away from infections (though, of course,
there is the risk when they put it in that someone is careless).

But use of the thing at home has to be meticulous. We did it every eight hours for five weeks
to infuse antibiotics. Each time, the port had to be sterilized, the line flushed, and remembering
to take each step in the right order while sleep-deprived was a challenge.

I hope it’s working well with you. Most hospitals will send a nurse around now and then to make sure you’re doing it right.

By: Jenonymous

Jenonymous — Fri, 19 Feb 2010 17:14:35 +0000

Steve Gilliard (famous liberal blogger, alas, now dead)is now in his current state partly due to having such a line installed.

Basically, they can send a mainline of infection to the heart, which is what happened in his case (as well as a possible infection from a saline tube that was put in one of his neck veins).

His PICC was getting infected constantly, and in the end it weakened him to the point that he got a second heart valve infection (after getting surgery for his first) and that did him in, alas.

RIP, Gilly.

By: Marc

Marc — Fri, 19 Feb 2010 14:02:41 +0000

I managed to locate a reliable source of information (UK NHS) on how various PICC complications are managed and what procedures are involved, should they occur. A handy guide on what symptoms to look for.

http://www.wales.nhs.uk/sites3/documents/357/ComplicationmanagmentofPICCs.pdf

Also, stats on complications and a detailed study by the ICS.

http://journal.ics.ac.uk/pdf/1002095.pdf

Best wishes