Originally Posted by Schmoo1022
I am sorry if this is a dumb question ( I know there are no dumb questions though,right?) Any way, I work in a very small LTC facility, and never get IV's. We are getting an admission with a double lumen picc line. He was supposed to get TPN, then it was decided against. He is still going to get IV ABX thru it. My question is, does it matter which port he gets the ABX thru? The ABX are q12, would you flush both ports?
Any answer, help would be great!
Yes.. You would flush both lumens and many protocols delinelate a q 12 hour flush.
So, If it is a open ended IV catheter, both lumens would be flushed q 12 with saline and heparin. However if it is a groshong, the lumen that you will use for IVAB will be flushed before and after the IVAB with 5cc NS (or per your P&P). The other lumen should be flushed at least once a week with NSS.
As far as which port to use... Normally a DBL lumen PICC will have one lumen that will be larger than the other. (Remember the smaller the number, the larger the lumen) I will save the larger lumen for my blood draws as it will yield better. However, be sure to flush before and after with saline and if you're drawing through an injection port, Change the port afterwards.
Also remember, to give your injection cap a good scrub with an alcohol wipe before you access it with your syringe. I teach my students to do a 30 second scrub like a "juicer" prior to.
In addition, make sure your drsgs changes are done at periodic intervals per sterile technique. We do ours weekly along with the injection cap and PRN.
Those PRN times are important however... whenever your drsgs are loose or soiled
that is a PRN time. If the cap is comprimised (I've seen them covered in feces and CHEWED as flat as a pancake) Those are way past a prn time.
Hope this helps..
DD
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