PICC lines

Nurses General Nursing

Published

Hi

My unit has had it's share of central lines and Hickmans .. but we have admitted a fellow for pain management. He has a PICC.

Have not had to care for him, as yet, but start a set of mids soon and am just kind of curious as to what others may have to say with regards to care of this apparatus.

I know you never use less than a 10cc syringe .. drsg changes are wkly, flushes are either N/S or hepaline qshift or pc drug instillation .. have never taken blood from one of these lines.

Any info will be much appreciated .. this fellow is an add on to the 2 ventilated pts we rec'd a day prior to his arrival !!

No wonder half the staff is burned out !!

Thanks in advance

Marilynne

:)

I think PICCS tend to be occluded more often, but not much different to take care of than a central or a Hickman.

We use the same procedure for aspirating and flushing as we do for the others. The only thing I have noticed personally with the PICC is they work better if you draw the blood back slow, they don't seem to aspirate as fast as a central.

Hope it helps

We care for a LOT of central lines in the community, and that's what a PICC line is (Peripherally Inserted Central Catheter). So, their care is identical, as far as flushing and dressing and cap changes. I never thought of it until some of the other posters pointed it out, but they DO tend to occlude more often than Hickmans, probably because they are longer.

One thing to watch for: we are getting a number of new catheters in the community which do not require hepalean or positive pressure flushes. They are the CLC 2000 and the PAS V. Both have special valves that prevent blood backflow into the line, and if you use positive pressure, you will actually prevent the valve from doing its job. The only way to know which sort of line you're dealing with is to learn to recognize the connector on the end (or check the patient's chart, but often we don't have that option in home care. I've wound up calling the hospital a few times to ask about what type of line it is, and how to care for it.)

We care for a LOT of central lines in the community, and that's what a PICC line is (Peripherally Inserted Central Catheter). So, their care is identical, as far as flushing and dressing and cap changes. I never thought of it until some of the other posters pointed it out, but they DO tend to occlude more often than Hickmans, probably because they are longer.

One thing to watch for: we are getting a number of new catheters in the community which do not require hepalean or positive pressure flushes. They are the CLC 2000 and the PAS V. Both have special valves that prevent blood backflow into the line, and if you use positive pressure, you will actually prevent the valve from doing its job. The only way to know which sort of line you're dealing with is to learn to recognize the connector on the end (or check the patient's chart, but often we don't have that option in home care. I've wound up calling the hospital a few times to ask about what type of line it is, and how to care for it.)

If it has clamps, it has no PASV or Groshong valve in it, and thus needs hep lock flush. No clamps= anti-reflux valve.

A well placed PICC is a work of art.

I think each hospital usually has its own flush protocol for all the different line types. You might try looking it up on your computer site at work that supplies the protocols for your facility.

Often, if you draw lab from PICC lines, it will 1. sometimes hemolyze, 2. creates a larger risk of the line becoming clotted 3. will skew lab results if IV fluids running through the line are not off long enough and 4. even when they are off long enough, it will still sometimes skew lab values...... so, if you get a lab result that was drawn from a PICC, my best advice is to re-draw the lab via peripheral stick to compare results.

In our unit, we don't tend to use a PICC line for blood draws because the majority of us believe it decreases the life of the line too much, and while it would save the patient some sticks, it would be much harder to just put in another PICC line.

Also, our IV team comes around every 3 days, and does a sterile dressing change to PICC lines and they replace all the caps, etc..... It's the only dressing we don't change ourselves. :)

Hope that helps! :)

Reminder: Just because that's the way -I- prefer to do things, doesn't necessarily make it the only right way. :)

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