J Infus Nurs 2017 Jul/Aug;40(4):232-237
Vascular Access Department, St Joseph's Regional Medical Center, Paterson, New Jersey (Mr Ostroff); PICC Excellence, Inc, Hartwell, Georgia (Ms Moureau); Greenville Memorial University Medical Center, Greenville, South Carolina (Ms Moureau); Griffith University, School of Nursing and Midwifery, Brisbane, Australia (Ms Moureau); and Alliance for Vascular Access Teaching and Research, Brisbane, Australia (Ms Moureau). Matthew D. Ostroff, MSN, RN, AGACNP, CRNI®, CPUI, VA-BC, CEN, recently completed an acute care adult and geriatric nurse practitioner certification and a master's degree from Drexel University. He is currently an advanced practice nurse at St. Joseph's Regional Medical Center, Paterson, New Jersey, where he performs ultrasound-guided peripheral and central vascular access device placement. Nancy L. Moureau, BSN, RN, CRNI®, CPUI, VA-BC, is a researcher in conjunction with Griffith University, where she is pursuing a doctorate in nursing research. She is also a vascular access staff nurse with Greenville Memorial University Medical Center, where she places ultrasound-guided peripheral and peripherally inserted central catheters. The owner of PICC Excellence, Inc, Ms Moureau also is an educator, consultant, and legal expert on vascular access.
The majority of peripherally inserted central catheters (PICCs) are currently inserted with the aid of ultrasound guidance in the middle third of the upper arm. A growing patient population is presenting with challenging vessel access requiring placement of the PICC in the high upper third of the arm. To avoid this suboptimal exit site, a subcutaneous tunneling of the PICC is established away from the axilla to a more appropriate skin exit site. Read More