Withdrawal of blood from piccs

Yes, one of the benefits of PICC lines is the ability to draw blood.

Yes but it isn't always easy and you have to make sure to flush well. Or you will clot it off.

Can blood be withdrawn from piccs

While it is true that blood can be drawn from A PICC, it is important to remember that some will give you a better blood returns than others. A 3 FR PICC is usually unreliable in yielding a return due to its smaller size. 4 or 5 Fr PICC"S will do better, but remember it is a slow steady withdraw on the syringe as the blood not only has to come a long way, but you don't want to collapse the catheter with a brisk withdraw method and negative pressure on the syringe barrel.

Be sure to change injection caps after the procedure if you aren't doing a direct connect.

DD

Can blood be withdrawn from piccs

We occasionally place PICC lines for frequent blood sampling only.

But just as the other poster stated, you'll be better off with a 5fr or larger line for routine blood sampling. Also, you need to perform good flushing immediately after aspiration of blood, because it can easily and quickly build up causing partial occlusion or the inability to aspirate blood. Cathflo will usually fix it.

I find that many times labs are off when drawn off PICC lines. what is the proper amt of blood to waste when fluids are running? Also could you draw coags thru a PICC which has heparin running? What would be the process without throwing off the labs by stopping the infusion or by not wasting enough blood?

I always stop IVF/TPN/Heparin for 5 minutes before drawing labs from PICC lines. Our policy is to waste 5cc's of blood, but I usually waste 10cc's. And, if it's a double lumen, make sure that all fluids are turned off. . I forgot to in the past and wondered why the blood glucose was 500 and the K+ was 6.0! If you're drawing coags, definately make sure heparin is OFF for 5 mins, flush with 20cc's of NS and draw a good waste. Some institutions require peripheral draws for coags, but I never had problems if I followed the stop/flush/waste system. PICCs are wonderful if maintained properly!

Blood flow through the SVC is around 2L/min---some variation with fluid status,patient size,etc. but it's fast enough that you probably don't need to wait a full 5 minutes. Turning off all pumps is indeed crucial as is a good flush and appropriate waste. Here's a reference:

Journal of Infusion Nursing

Volume 26(5), September/October 2003, pp 285-293

Drawing Blood Samples From Vascular Access Devices: Evidence-based Practice

Frey, Anne Marie RN, BSN, CRNI

A link:

http://www.hadawayassociates.com/

Look under the Clinical Articles section for the one on blood sampling.

Another link:

http://www.iv-therapy.net/node/702

I agree it depends on the size of the PICC a neonatal PICC is only a 1.9FR so you are not allowed to draw labs or infuse blood with these lines. The CICU in our hospital has a tendency to disregard this policy when they care for cardiac babies, and the lines clot off.

We no longer change caps after draws, have studies to support this practice. We use positive displacement caps and flush with 20ml non preserved saline after blood draws.

Can blood be withdrawn from piccs

yes i have been doing it sine 1989 stop all iv fluids for 1 full minute withdraw approx 2x the priming volume of the line.....most policies say 3-10 mls,,,withdraw sample slow and steady so as not to break cells...be patient it is not a cordis....... trasfer specimen and immediately flush per your protocol do not mistake your discard for your speciman any line with a persistant withdrawl occlusion should be treated with tpa (cath-flo) hopethis helps mary the iv nurse

we do not change our caps either after a blood draw since we switched to a positve pressure cap