Q&A PICC Insertion – needle bevel up or down?

Q. In PICC Excellence online course “Inserting PICC with US” you show the needle in the bevel down position. I was taught the bevel is up doing vascular accesses. JH 2/13/21

A. The common practice for inserting any needle is bevel up, however, with ultrasound needle guidance bevel down is sometimes used, often just after insertion, to prevent advancement of the needle point through the back side of the vein. Especially with UGPIV insertions with small veins, bevel down is preferred once you enter the vein and start advancing deeper into the vein. Bevel down is a more advanced technique that can be used effectively.

Nancy Moureau PhD, RN, CRNI, CPUI, VA-BC and CEO of PICC Excellence, Inc. Hartwell, GA 30643

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