Use of blind placements of peripherally inserted central catheters in burn patients: a retrospective analysis.

INTRODUCTION: Safe and reliable vascular access is essential for the treatment and care of burn patients. Peripherally inserted central catheters (PICCs) are widely used for various groups of critically and chronically ill patients. However, the information about PICC use and management for burn patients is limited.

METHODS: The Institutional Review Board approved retrospective cohort chart review included all burn patients at a single center who received one or more PICCs (n=106). Blind PICCs were placed by an intravenous clinical nurse specialist (IV CNS). Data were collected from PICC records and included general demographics, as well as PICC insertions, management, and removals.

RESULTS: About 42% of cases were in the cubital vein, 39% in the basilar, 14% in the cephalic, and 3% in the brachial veins. In 75% of the cases, gauze dressing was identified as the primary form of routine PICC nursing care. About 62% of all patients had their dressings changed every 48h and 37.5% had dressings changed daily. The average length of time each PICC remained in place was 18.5 days. About 16% of the cases were identified as having PICC-related complications, including one infection, two occlusions (2%), one edema at insertion place (1%), and 12 cases of mechanical phlebitis.

CONCLUSION: Although PICCs are adequate for burn patient care, there are no protocols or guidelines covering rational and safe usage of PICCs. Standard guidelines on PICC placement and management specifically for burn patient should be developed.