Innovative Positioning for Peripherally Inserted Central Catheter Insertion on a Prone Patient

Our hospital, a 220-bed, level-1 trauma center, sees an increase in patients with acute respiratory distress syndrome (ARDS) during the winter months. To maximize an ARDS patient's lung capacity and improve mortality rates (which can be as high as 40%), it is common for a critically ill patient to remain intubated in a prone position until ventilation/perfusion rates improve. When central line access is needed, but the patient cannot tolerate staying supine for the procedure, it was hypothesized that a peripherally inserted central catheter (PICC) could be placed with the patient prone. Six patients received PICCs with a 100% success rate. The ability to place a PICC in any critically ill, prone patient can expedite the administration of fluids and drugs by the critical care team and assist them in providing optimal care.