A retrospective look at tip location and complications of peripherally inserted central catheter lines

In 1982, Southern Regional Medical Center in Riverdale, Ga, instituted a program for selected intravenous nurses to insert and manage peripherally inserted central catheters (PICCs). At present, approximately 125 to 150 PICCs are inserted annually by eight experienced IV nurses. In this retrospective study, the authors review medical record data on PICC insertions that occurred between January 1987 and December 1991. The optimal tip location is defined as the superior vena cava (SVC) and an anterior-posterior one-view chest x-ray is performed to confirm tip location. This study focuses on the initial location of the PICC and actions taken to correct the initial tip placement if not in the SVC. Medical records were reviewed for complications including mechanical phlebitis, infections, ruptured catheters, clotted catheters, or vein thromboses. The frequency of these complications, their prevention, and management are discussed.