[mosjes]

hey all-
so we just merged with another group of rn's to form a new partnership, and we are finding many many many many differences. one of the most frustrating is that our rn's (through the harpings of myself) are instructed to not let central lines run to gravity. the other rn's are running many lines to gravity. i was under the impression that this is a bit of a no-no. unfortunately, i am a bit of a harper when it comes to process and best practice, so i am annoying myself with "i swear it's supposed to be like this, i just don't know how i know". so, could someone please help me out with a little rationale or possibly a link to somwhere where i may print out something official for my new friends? or, let me know that i was mistaken? thanks in advance.

[cannulator]

cannot think of any prohibition against running a central line to gravity . We always try to run platelets to gravity, and it's often through a port, PICC or hickman. However, often it doesn't work too well...just meets too much resistance and a pump is just all-around more efficient. Still, it's not because of any reason other than expediency.

[neneRN]

We run by gravity into our central lines more often than not.

[mosjes]

so,
i am hearing from our CNE that they are not to be put to gravity. do you guys have any rationale or links for the "okay to gravity" arguement? sorry to be tenacious, i am just a best practice freak.
thanks for the posts,
jes

[brent_25]

We run CVC's to gravity all the time (mainly because we simply don't have enough pumps in the hospital for all the CVC's we have!)..but when we do - it is our policy to hang micro-drip tubing instead of macro, to decrease the chance of the pt inadvertently receiving a bolus (for all those fidgety pts that may have a tendency to play...).

The only time we insist on a pump is for infusions that require exact (heparin obviously) or someone on multiple meds where we want to ensure infusions are given on time...

Brent.

[aec1]

The central location of the tip has never been the issue as far as I knew. It was whether the infusions being administered could be delivered that way. There are of course many that I would not such as high doses of Potassium, Ampho, Acyclovir etc... Vanco (at least not without a dial-aflow), but Zosyn, NS, etc can.

Also look at whether a nurse is administering all doses or is the patient being taught (for home care)... then in most cases a flow regulator is most prudent. But if I am doing the administration and sitting right there I would feel comfortable giving Remicade etc gravity... and our policies give us that latitude.

[bobnurse]

a facility i worked at stopped hanging ivpb's to gravity because they were causing the lines to become clotted. The nurses werent getting to them to flush them after infusion and the negative venous pressures were backing minute amounts of blood back into the catheter causing occlusions.