I have a question regarding PICCs (or central lines, in general). I have seen nurses flush all three lumens of a Triple-lumen PICC with a single 10ml prefill NS syringe and then a single heparin prefill syringe, and I have also...
Our policy is 20ml flush after blood draw 10ml for just regular flushing. Also use the "Push-Pause" method. If the PICC has clamps on it then we presume it is open-ended and it gets Heparin. No clamps=no Heparin because it is closed-ended.
Each lumen gets its own individual syringe of 10cc normal saline, blood draws change the caps then flush with 20cc normal saline . We use the pulsilate technique also. Lines are flushed every 8 hours and with each blood draw.
Our hospital policy is to flush with 10mL NS using the pulsatile method Q8 hours. We no longer use heparin. We did a test/study before adopting this policy, and the result was that central lines did not occlude any more frequently with the NS flushes than they did using heparin, and NS does not carry the risk of HIT that heparin does.