I have a question regarding the infusion of blood through a midline (dual lumen) or a PICC. Is it ok to infuse blood through one port and another IV med through the other?
I had a patient with a power PICC that was placed midline (tip not in SVC.) She had PPN infusing through one port. I had an order to infuse 2 units of PRBC. While infusing the blood I stopped the PPN. A coworker told me that was unnecessary, however I was taught that blood and TPN/PPN always had to be infused by it's own...any thoughts? I've tried looking at my hospital's guidelines and have searched the web but can't find anything specific....
Also, if anyone could recommend any good websites relating to infusion therapy I would greatly appreciate it!
Oct 6, '08
Go to www.ins.com
or google intravenous infusion nurses. I think dual PICC lines have separate lines. The reason that you do not infuse blood with any medication is to prevent hemolyses. If a dual picc line has separate lines it stands to reason that two different forms of fluids (blood and TPN) can infuse without interacting. When I worked med/surg I have, with the counsel of my charge nurse, I have infused antibiotic on one port and blood in another port. And of course monitoring 15minutes. Check the website and let me know if I am wrong.
Oct 6, '08
Not sure what sort of lines (i.e. 'brands') you have at your facility. The PICC lines, triple lumen or quad lumen caths I have seen hall have their own lumen until they get to the vessel. So you can run things in separate lumens that normally are incompatible (sp), because they will not mix in the catheter at all.
It's like a foley cath. You have one lumen the urine exits the body from, with a separate lumen that the balloon is filled through. One catheter, 2 lumens. In this case, urine and balloon fluid never mix. In a PICC or 3-4 Lumen cath, the lumens just deliver their fluids through separate points on the side of the catheter (with one port delivering thru the tip).
Port A, \ = exit for Port A
Port B -----------------------------/----------\--------> Exit port B
Port C, / = exit Port C
I know this is a sorry example of a picture, hope it helps. I did an image search, and you couldn't really see anything. See if you can get the rep to come and bring you and your co-workers an 'out of body' catheter (lol) so you can see it better.
Hope this helps!
Oct 7, '08
Yes it is OK. Each lumen is separate and therefore you can administer completely incompatible medications and solutions. The reason.just for your information,that blood is administered by itself is to reduce the risk for bacterial contamination, In addition any multi-lumen CVC,PICC or midline regardless of the manufacturer can be used in this fashion`,with each lumen considered a separate lumen or port. Do not allow that midline to be used for a power injection. The PICC nurse took a power and cut it to a midline length and thus used it as an off-label use. OK to use it as a midline (though a little touchy) but please do not use for power injections