Use of central line/picc line for routine lab draws
- 0Dec 29, '10 by Amanda Schmidt, RNIs it ok to use central/PICC lines to draw routine labs from just to save the patient a stick?
- 1Dec 29, '10 by CharmedJ7I think you're going to find the answer to this depends on your particular floor, institution, etc policy. Sometimes physicians/nurses are very against the use of blood draws from PICCS b/c it does run the risk of compromising the integrity of the line which can be seen as not worth it for a little stick. On the other hand, many people are hard sticks and if they have a central line in place, particularly a PICC, phlebotomists cannot draw from that arm which only really leaves the other, which can be difficult to near impossible depending on the pt. Also, is the pt on TPN? TPN running through the same line can throw off values, esp of electrolytes, so that is often a contraindication to drawing off the PICC, although it is possible to still do it if you turn off the TPN for a period of time, flush well, etc.
On my floor we draw off the PICCs all the time except in MOST cases when pt is on TPN. When I was working in an infusion center too we drew off central lines of all pts who had them. I personally love to draw off central lines, it's quick, it's easy, and I think saving someone a stick, or several, is important. That and peripheral draws in my hospital are done by phlebotomy, so with central draws I can control when the lab is drawn - ever had a "stat" troponin drawn 4 hrs later, or not at all? Some people say drawing off a central line will make the labs unable to properly analyze them, but thus far I have never found that to be the case.
Last thought, I believe mediports are in general more suited to blood draws than PICCs, but that said I doubt anyone would ok accessing a mediport for that reason unless the pt had no other access.
Does that help?
- 0Dec 29, '10 by sunnycalifRNQuote from Amanda Schmidt, RNI'll only use it, if I don't have an art line. As long as you've stopped any drips or infusions running through the other line(s) of the PICC or central line, and have flushed with at least 10-20 ml of NS, then, sure, I always try to save my patient from an unnecessary stick. If checking the PTT for a heparin drip, I will use the art line, if available, or stick the patient on the other side. I've seen too many erroneous high PTT's from inadequate flushing of the PICC/central line.Is it ok to use central/PICC lines to draw routine labs from just to save the patient a stick?Last edit by sunnycalifRN on Dec 29, '10 : Reason: clarification
- 1Dec 29, '10 by Lil'mama, ADN, RNWe do not draw blood from PICCs as per our policy but we do from other types of central lines unless there is an order that says not to OR the line doesn't draw blood. We do have some people with portacaths that work well but don't draw blood.
- 11Dec 29, '10 by OrionQuiltsRNI spent six months receiving chemotherapy for lymphoma this year. Lymphoma is gone! I am well and anxious to find another RN job. I had a power PICC in my right arm. It was probably the best thing about this past year. I had blood draws every day through my PICC, sometimes twice a day. All my IV fluids, chemo, and blood transfusions went through that double lumen. Once the PICC line was established I never had another stick. I loved my PICC line.
- 0Dec 29, '10 by MunoRNQuote from Amanda Schmidt, RNThat's a big reason why we put them in, in fact sometimes it's the only reason why we put them in, either they need frequent draws and they are a hard stick or they aren't necessarily a difficult stick but they are likely to need fistula placement at some point.Is it ok to use central/PICC lines to draw routine labs from just to save the patient a stick?
We don't draw ptt's out of a lumen that has had heparin in it at any time, and you shouldn't trust glucose or potassium levels to be too exact if you've had Dextrose or KCl in the IVF running through that lumen. There is a theory out there that the line will occlude quicker, although with proper technique there's no evidence to support that, and PICC manufacturers recommend that you check for blood return on a regular basis anyway.Last edit by MunoRN on Dec 30, '10