[Glad2behere]

Gosh, I never knew there was so much difference here.

We use PICC lines all the time for draws, in fact, our protocol states that if a patient has to be stuck more than four times for the anticipated hospital stay, has inaccessible peripheral locations, or poor perfusion in the extremities, or disoriented and threaten a peripheral site, or on a ventilator, the PICC line goes in. We do use a 10 cc syringe, draw 7 cc, discard, draw the sample up to 20cc, and then flush with NS 7cc. No collapsed lines, and better infection control. All meds given must be given with at least a 1 to 3 ratio of NS, over 3 minutes.

[NicuGal]

Another NICU here....we only draw off for cultures,nothing else...we have lost one too many lines from clotting. We also use a 5-10 cc syringe as advised by the manufacturer. We aren't supposed to use a TB syringe...it exerts way too much pressure.

[emily_mom]

Originally posted by JNJ


Incidentally, anyone out there with a line older than 18 months? What's the record on this?

Just had an oncology pt the other day who's line was 2 years and 3 months old. She was very attentive to sterility when we were drawing on it. Don't blame her...it's her lifeline...

[renerian]

End of discussion. They are the ones who say yea or nei.......I have bigger fish to fry.

renerian

[ocankhe]

Is this the MD's preference known to the staff, or is it written as order on patients chart?

[NRSKarenRN]

Agree with above posters: Lab draws can be done on any PICC
4 FR or greater using 10cc syringe. Purpose of PICC is to SAVE VEINS!

From Bard--manufacturer

QUESTION: What syringe size is recommended for use with various catheters?

ANSWER: It is recommended that a 10cc syringe or larger be used to infuse or flush catheters. This includes Pediatric and neonatal catheters. Infusion pressures should never exceed 25 psi because pressures higher than that may damage blood vessels and viscus. A two-pound weight equivalent force on the barrel of a 3cc syringe generates pressure in excess of 25 psi. The same two-pound weight equivalent force on the barrel of a 10cc syringe generates less then 8 psi of pressure. Please refer to the Instructions for Use for further details.

More info here:
http://www.bardaccess.com/faq/q_a.html

Vascular Access Infections in the Outpatient Setting--Power Point Required
www.idlinks.com/slides/ins.ppt

eMedicine - Venous Access Port Problems : http://www.emedicine.com/aaem/topic472.htm#target1


Patient advocacy alert!!!!
Sounds like many nurses need to check with the manufacturer of IV device being used in their facility for education on devices and use to discuss concerns with prescribing doctors and creating up-to-date policy and procedures!

[jemb]

Tory, I just want to approach your question from a different angle here. From some of your previous postings, it is obvious that your employer is very lax about training. My guess is that the docs are not wanting blood to be drawn from PICC lines on their patients because of a history of the lines becoming clotted or having ither problems after blood draws have been done by inadequately oriented/trained staff.

It should not be a problem to do blood draws and maintain the line. But when there is either no policy guideline in the facility or this information is not available and taught so that the procedure can be uniformly practiced by all the nurses on the unit, problems can and will result.

[KailuaNurse]

At my facility we are allowed to draw labs from PICC lines as long as they are a 3 fr or bigger. This is great for the pediatric population since it means that they don't need to experience another poke.

[BrandieRNq]

My facility has recently added prefilled saline syringes to our supplies in 5cc and 10cc sizes. I can't remember the company they are from. The interesting part is that the barrel of the 5 cc syringe is the same diameter of the standard 10cc syringe which means the pressure is supposed to be the same that would be exerted by the 10cc syringe. We do draw from PICC's routinely.

[fancynancy]

"look it up" check out the website for the PICC manufacturer, read their guidelines for use. compare it with your nursing policy and procedures. Make use of the websites that are reliable, the Intravenous Nurse Associations have a list of good websites. oh! be sure to note the last time your policies and procedures were up dated. check their references and how recent the references are. What You do is What you get.