clogged picc line

Nurses General Nursing

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My son is in iccu as an lpn i know nothing about certain things. 1. We are told that d/t multiple intubations multiple bouts of aspiration pnuemonia they are having a very hard tlme weaning him back off of vent. They are also saying that from bere on out each time he is intubated will get harder and harder to get him back off it why? 2. When pic port becomes clogged are you suppose to use excessive force to try to flush it clear? Thanks for any help.

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I'm sorry to hear about your son. I hope things turn around for him real soon.

Per the TOS, we cannot give medical advice.

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I don't want medical advice I just want to know why multiple intubations and aspiration makes further intubation harder to wean off of and if a lot of force in a saline flush is what is done to clear a clogged pic line? I am confused is that medical advice and I just don't realize it? As a nurse they are questions I thought I could answer if I knew the answer but if it is medical advice I don't want to get myself or anyone else in trouble. Please reconsider and let me know I honestly did not mean to break the TOS or make anyone else break them I am sorry. Thanks

My son is in iccu as an lpn i know nothing about certain things. 1. We are told that d/t multiple intubations multiple bouts of aspiration pnuemonia they are having a very hard tlme weaning him back off of vent. They are also saying that from bere on out each time he is intubated will get harder and harder to get him back off it why? 2. When pic port becomes clogged are you suppose to use excessive force to try to flush it clear? Thanks for any help.
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Specializes in Vascular Access.

As far as the PICC line is concerned... One SHOULD NOT be using excessive force when they meet an occlusion. Doing so puts undue pressure on the catheter and could either rupture it, and send a catheter emboli, or send a blood clot, which could be quite serious depending on the clot's size.

The key is gentle aspiration. They should try direct connection of their syringe to the catheter and gently aspirate, then try to flush, gently aspirate, try to flush. I may do this for 3 minutes, but am usually successful in clearing the line. If it still is persistantly occluded, they should be using Cathflo and clearing the line. It is important to remember, however, that Cathflo will NOT clear a line in which the occlusion is a precipitate, which may form from two incompatible medications given in the same lumen.

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Specializes in Pediatrics, Emergency, Trauma.
I don't want medical advice I just want to know why multiple intubations and aspiration makes further intubation harder to wean off of and if a lot of force in a saline flush is what is done to clear a clogged pic line? I am confused is that medical advice and I just don't realize it? As a nurse they are questions I thought I could answer if I knew the answer but if it is medical advice I don't want to get myself or anyone else in trouble. Please reconsider and let me know I honestly did not mean to break the TOS or make anyone else break them I am sorry. Thanks

Your question poses a possible conflict...If we answer your question, and then say "well, on AN they said...." that is where the conflict comes in.

As for PICC lines...did they say the PICC line was clogged? As a PICC certified nurse, I have come across a couple of lines that may appeared "clogged" but may have some form of pressure compromise from a multitude of issues, not necessarily "clogging"... PICC lines are flushed with heparin as well as saline. I say to ask what the policy is and explain that you want a rationale on the PICC line care, as well as the vent. From what I gather as a trach vent nurse, multiple aspirations and intubations do make it harder for vent weaning depending on your son's diagnosis and pathology. Again, I suggest to have his healthcare team clarify what is his pathology on WHY he cannot be weaned, and the rationale.

I wish support for you and your son during his recovery!

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Thank you very much for the responses. Thank you also for the explanation about someone possibley saying "on AN they said" I would hope that neither myself or anyone else would do such a thing I can certainly understand the concern. Thank you

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Specializes in Vascular Access.

Remember, ALL PICC's aren't flushed with Saline and Heparin flush... In most places, anyway.

Those PICC's which are valved, like Groshong PICC's are NOT flushed with Heparin, nor should they be. If you can avoid heparin, do it to avoid HIT, and with most valved IV catheters, I avoid it.

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Specializes in Infusion Nursing, Home Health Infusion.

Agree with IVRUS. The term occluded is a better term to use to describe any central line that does not flush well or at all. This may be due to a thrombotic cause,mechanical problem or a drug or mineral precipitate. A nurse should assess the situation and rule out each possible cause and then narrow it down to the most likely cause. Sometimes it is obvious and other times it is not. I have seen many a nurse rush to give Cath-flo that was not effective and when they finally called us I was able to figure out it was most likely a mechanical cause when I asked a few questions. Of course, I went to assess and was correct the last few times this has happened.

You never want to force a flush because you can cause catheter fracture (rupture) or weaken the catheter and then it ruptures soon thereafter. I would ask for the PICC or IV nurse to assess the line of that is available as they deal with these issues all the time.

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Specializes in ICU, telemetry, LTAC.

Another thing the nurses handling the picc line should consider is changing out the port on the end. The luer lock ports themselves need to be changed every few days, or after using the port to give blood or to do a blood draw. Using a push-pause technique on the flush syringe in between solutions infused, also helps the port to clear itself of bits of precipitate. It's like, on 10cc flush, push 1-2 cc, pause, push 2cc, pause, etc. If the thing is clogged with, say, LR or D5 solutions, try pulling back the syringe and get blood in the line, then push it back in, repeat twice, then use a good saline flush. Blood itself will help clear some of the solution, but you have to do a good job of pushing the blood back out of the line.

Also, the patient's position and how their head is turned may influence the ability to draw blood back. And, if the patient's line flushes well but won't draw, an ultrasound wouldn't hurt just to rule out a nice little DVT forming around the line.

Every patient's lungs have different background things going on; it sounds like your son has some reason the lungs keep requiring mechanical help, it would be a good thing to ask either the pulmonologist or the nurse to explain it to you a bit more. Sometimes the staff doesn't explain much because they think a nurse knows what's going on. Tell them you really need the explanation.

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Spoke with pulmonologist this a.m. he did a nice job of explaining things. You all are correct you never push if an occlusion is even suspected. You all are wonderful educators thank you very much. The situation has been resolved and I feel a lot better. Was even put in touch with another nurse whose father has chronic critical condition. She too becomes dumb as a box of rocks when it comes to dealing with her father. Obviously we aren't dumb but it is apparently not uncommon to kind of lose the ability to think clearly as a nurse when dealing with your own loved one. I appreciate everyone's help. Hugs to all

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Specializes in RN, BSN, CHDN.

I am pleased that the Dr explained things to you.

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