Trauma Team 1 wrote:
My question is WHY does it seem like most of the pt's that i encounter on my daily run who have P.I.C.C lines 90% of them are clogged?
One of the reasons I have witnessed for PICC lines clogging is erroneous thinking that a KVO of 10-20 ml/hr will keep the line open without having to flush it (often done on PICC's with unused/multiple ports). Our unit has standing orders for flushing of all PICC ports, BID with 10 cc saline, push/pause method. Actually, from what I understand even ports that have IVF and other drips continually running should be paused and flushed out twice a day because it's the "push/pause" pressure that helps keep the catheter patent (not just a steady stream).
Also, the PICC can sometimes become lodged against the side of the superior vena cava in such a way that it is no longer patent. I have seen clogged/unusable PICC's miraculously become patent again when a patient is turned and the cathether (obviously) moves away from the wall of the vessel.
Believe me, nurses would much rather draw a sample off a PICC line themselves then wait 1-2 hours for phlebotomy to show up (at least at my facility). PICC's are simple to draw from and make a nurse's life a lot easier in other ways too (no infiltration to worry about etc), a nurse who would puposely let a PICC clog (out of sheer laziness) is one who is shooting herself in the foot by making more work for herself. So, please don't assume that lazy nurses just let PICC's clog up because phlebotomy will be in to draw the samples anyway :trout:
Why not try to be part of a solution?? The number of clogged PICC's you are seeing is not helping the nurses job or patient care. Maybe talk to the CNS on the floor or to your phleb supervisor about what you are seeing and your concerns (about the number of clogged PICC's, not the assumed laziness of the staff).
I asked why the PICC wasn't being used.
One of the reasons the PICC may not have been used is if a heparin drip was running through it and the test being drawn was a Coag screen (these are typically done q6h when a pt. is on a heparin drip). In that case a peripheral stick would be required, because to draw a sample from the same line that the heparin was running into would result in a PTT so high that it could be entered into the Guinness Book of World Records!!