blood draw from PICC

[littlegreenfrog]

Ok, I know this is a simple thing, but how do you draw blood from a PICC? This is how I do it:

Flush PICC with 10cc saline then pull back 10cc blood (to waste)

Hook up that vacuum-thing and put the blood into the tubes

Flush with 10cc and change the end piece (cap thing) of the PICC

Am I doing something wrong? (I left out obvious parts like wash hands, glove, check armband, swab with alcohol, etc)

Also, if a pt is getting a heparin drip, can you draw from the PICC or do you always do a peripheral blood draw for Ptt? If you do draw from PICC, how long do you stop the drip for before?

Thank you - when I ask my fellow nurses I get a million different answers and I can find no place where hospital protocol is written (I work at a s h i t hole of a disorganized place)

[tokmom, BSN, RN]

Our policy for heparin is to get a peripheral stick unless the person has crap for veins.

Otherwise, it says to do the same. Flush, waste, draw and flush all 10 cc's (less usually for the draw). Cleaning of course, gloves, etc..

[rkealy, BSN]

Don't change caps with blood draws....dont take off for blood draws....change caps with dressing changes as your facility states (usually every 72 hours or q7 days)

[That Guy, BSN, RN, EMT-B]

Funny, our facility says you have to change the caps each time with a blood draw from a central line because going through those blue t-caps can mess up the chemistry/blah blah

[rkealy, BSN]

Taking off your caps sig increases risk of infection...I would look at changing brand of caps

[ParkerBC,MSN,RN, PhD, RN]

Don't change caps with blood draws....dont take off for blood draws....change caps with dressing changes as your facility states (usually every 72 hours or q7 days)

Our policy is the same with the exception of drawing cultures...we then draw directly from the line (without the cap on) in case of bacterial growth on the cap. We don't want a false positive.

[ParkerBC,MSN,RN, PhD, RN]

Funny, our facility says you have to change the caps each time with a blood draw from a central line because going through those blue t-caps can mess up the chemistry/blah blah

Our facility is looking at that too.

[Sun0408, ASN, RN]

Our policy is to change the caps with each blood draw, diprivan tubing change and with each new TPN bag change.. We haven't had a BSI or an increase in infection since we implemented this. Actually we haven't had a BSI in more than 2 years. That includes our PICC and TLC.

[CrazierThanYou]

I flush with 10cc, draw 5cc waste. Then I use a new, empty syringe to draw however much blood I need. Then I flush with at least 30cc. If I still see blood in the cap, I change it. We always draw from PICCs. No way would a doctor approve a PICC just for blood draws. Not at my hospital.