Quote from graduatenurse
i work at ltc facility and i had a patient with picc to receive iv vanco. this morning midnight shift nurse couldnt flush picc line because it was plugged. so the morning nurse called doc, sent him to er and came back on my shift. er physician called me and asked me what the problem was i told him becuase his picc was plugged. he said was a line clamped? i said we unclamped it and tried to flush it but there was too much resistance. then er doc told me we should never ever clamp picc line. this is the first time i ever heard of this. since i worked as a nurse, we often clamp either picc line or peripheral line to prevent blood from backflowing after we give medication and flush the line. so does clamping picc line cause line to clog? we clamp it after we flush it with saline.
and second what is your facilitys protocol regarding flushing picc line? if patient is receiving medication like vanco, shouldnt it be flushed with heparin? we use sash protocol by flushing it with saline, med, saline, heparin. how often do you flush the line? thanks for any info.
as previous posters said, if the picc line has a clamp on it, use it and clamp using positive pressure flushing if your catheter is open ended and you don't have a positive displacement injection port on its end.
positive pressure flushing will decrease a reflux of blood into the iv catheter because if you are doing it correctly, you are injecting small bursts of saline and then clamping the catheter as you are pushing in the last 0.2-0.4 mls of the solution. if, however, your iv catheter has a positive displacement injection cap on its end (ie. flolink) , you flush the line using small bursts of fluid, and then leaving approx. 2/10ths of a cc in your syringe, you disconnect your syringe, wait 10 seconds then clamp your catheter or your extension set.
valved iv catheters, like the "solo" or "groshong" have a integral valve which remains closed unless negative or positive pressure is placed on the line with withdraw or infusion.
the md that spoke with you was not correct. and...it is a good thing that you stopped flushing once you met resistance. you do not want to blow a hole in the catheter or send a catheter emboli.
do you not work with a pharmacy that has nurses that can administer cathflo
if no one at your facility can? cathflo can be given which will open the majority of picc's when the line is not
occluded with a precipitate. of course an order is needed for it, as well as a knowledge on its proper use.
hope this helps..