Drawing Blood From PICC Lines

Nurses Safety

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I work on an Oncology unit where many pts have PICC lines. there are 3 drs that routinely start them for us. These drs say that we are not to use them to draw blood for labs. They have said that this will cause the line to collapse. At my hospital, the RN has to do lab draws from central lines/PICCS. Some RN's abide by this and have lab stick the patient for labs. Other RN's draw blood from the PICC reason being,....they don't have any veins to begin with (which is why they have the PICC). I would like to get your opinion on this. I am a fairly new grad and have made waves with this. I used to draw blood from them until I learned the drs said not to. So now I refuse to do it and have lab do it (often times they are unable to get enough blood or can't find a good vein). Just curious. Thanks!

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we use PICCS on our heme/onc kiddo's all the time....why stick them when they have perfectly good central access? just make sure you flush them really well, with at least 10cc's (this is for kids, may be different for adults)and they shouldn't cause you any problems...

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Specializes in LTC, assisted living, med-surg, psych.

You should not be drawing blood through PICC lines if the doctor ordering the labs says not to. This is something that needs to be brought to the attention of the people who make policy at your facility; it's up to them to determine whether or not this is OK. However, it sounds like the MDs need some education on this issue, because blood can easily be drawn this way as long as you are careful. I've always done it by withdrawing the blood a little at a time, both to avoid hemolyzing the sample and to prevent damage to the catheter, and then flushing the line per manufacturer's instructions. Never had a problem yet, except of course when the line was no longer patent for some other reason.

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I have often done blood draws on PICC lines in the community. You have to know what type of line it is, however. Some have special one-way valves that can be damaged by pulling back on a syringe. Read up on it, educate yourself, then, if necessary, educate the doctors. Why should we stick a patient with poor venous access if they have a PICC or central line (Hickman, etc.) in place??

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WE draw bloods on PICC,just like everyone say here,follow your facility protocol.It's ashame to stick someone if you already got access through a PICC.Talk to yuor charge nurse.

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Our guidelines state that we can draw from a PICC but only from lumens equal to or larger than 0.5 French. So maybe the size of the lumens have something to do with it?

Midlines cannot be drawn from; the catheter is too soft and will collapse.

We are not allowed to draw from a PICC when the pt has a heparin gtt, for obvious reasons.

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We draw from the PICC. Our PICC protocol calls for referral for a PICC line for "poor venous access", meaning no peripheral veins for blood draws.

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We draw from PICCs all the time, you just can't use a syringe bigger than 3cc.

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Could we talk about what the protocol says? I remember ours as Flush and draw using a 10 cc (using a smaller syringe creates too much pressure)>

Flush with 10cc NS

Draw 7CC - waste

Draw needed amount of blood for lab test

Flush with another 10cc (Creating turbulence)

Then rehook to running IV or flush with 3cc Heparin (with a 10cc syringe)

---- Check your protocol.... but using 3cc syringe is a BIG no no...

Great topic to discuss...

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Syringe size makes a difference. We use only 10cc. Pressure does make a difference.

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Specializes in Oncology/Haemetology/HIV.

I draw labs (other than PTT for heparin drip) from PICC frequently but have noted that some of the newer ones seem 'flimsier' than others. As far as I am aware, 10cc syringes are the standard for flushing/drawing for use with most VADs d/t pressure concerns, but have seen some Groshong PICCs crack no matter how carefully flushed.

My question would be to the powers that be, "Why are we placing PICCs in patients with poor vascular access, when we can't draw blood from them, by policy" - If they are insistant on not drawing blood from PICCs - there are plenty of other devices to use that can permit blood draws (as well as being less limiting of venipuncture - can't use the PICC arm).

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Quote
Originally posted by MiddleT

Syringe size makes a difference. We use only 10cc. Pressure does make a difference.

We've been taught that as well.

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