Do I have to flush before withdrawing a blood from a PICC even a 0.9 Nacl + k running

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I did not practice nursing for almost 4 yrs, and just started working again as nurse 2 days ago :)) it's my first time to draw blood from a picc, just wondering, if there is an IV running through the PICC like 0.9% NaCl + K 40 mmol do I have to flush before withdraw a blood?

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This is how I do it to reduce contamination I flush before I draw blood....

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Specializes in Med-Surg.

Stop primary. Flush 10ml NS. Withdraw about 10ml blood. Waste. Then take your sample. Vacutainers should not be used on PICC lines. Flush with 20ml NS. Always wipe the hub in between.

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Stop primary. Flush 10ml NS. Withdraw about 10ml blood. Waste. Then take your sample. Vacutainers should not be used on PICC lines. Flush with 20ml NS. Always wipe the hub in between.

Agrees to the above!!!

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Specializes in Infusion Nursing, Home Health Infusion.

HAVE EVERYTHING READY BEFORE YOU START

1 Stop all infusions going through ALL lumens of the PICC or CVC for at least one FULL minute

2. Scrub the needless connector for 15 seconds with IPA (alcohol)

3. Verify patency of the selected lumen ( On a PICC select largest lumen if that applies as draw will be a bit faster but anything can be used)

4. Discard at least 2 x the priming volume of the line (5- 8 ml is adequate for a PICC). Look at the discard and you can see the first part will appear a bit dilute and you can tell when it gets darker and you have no NS in that section of the syringe

5. withdraw your sample using a syringe (s), A 10 ml syringe works the best and draw slowly and consistently. Do not pull so hard that it vibrates b/c you will hemolyze the cells and then the results cannot be trusted. Do not use a vacutainer on a PICC.

6 Transfer the specimen into specimen tubes using a transfer device.Do not force the blood in.. let it fill on its own. May lab tubes now have a safety feature that does not allow the blood to drip or spray if used incorrectly.

7 Immediately flush the PICC with at least 10-20 ml NS and if locked with heparin flush if your facility is still using it. Improper flushing after a blood draw is a common cause of catheter occlusion

8. Make certain caps are clean and no bloody

9. label blood specimens at the bedside.

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hmm, haven't done any draws in quite a while, what is the reasoning for NOT using a vacutainer? Also, changing the cap after a blood draw used to be routine, not anymore?

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i see. i though since there is an IV running it's okay not to flush. if the PICC line is not use i will for sure flush it before drawing blood. anyway thanks guys!

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We always use vacutainers on PICCs,what is the reasoning behind the advice of not to?

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Specializes in Med-Surg.
We always use vacutainers on PICCs,what is the reasoning behind the advice of not to?

The same reason you are not supposed to use a syringe smaller than 10ml. Vacutainers cause a large increase in pressure in the lumen(s). Also, the other day I was looking at the standard orders for PICC line maintenance and it says in bold lettering NO VACUTAINERS.

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Specializes in Critical Care.

Please don't waste 10cc of blood out of a PICC. The waste should be 2 to no more than 3 times the priming volume. A Power lumen on a PICC has a volume of 1.7mls, groshong lumens are about half that, 3 times 1.7 mls is 5.1 mls. It's the patient's blood, not ours, please don't throw it in the trash without a good reason.

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Specializes in Infusion Nursing, Home Health Infusion.

Yes ..I agree on the volume...2 x the priming volume of the line is adequate as I stated. I was addressing all types of CVCs for the most part since a blood draw will be similar for all with some slight variations. Checking into the vacutainer issue as well since I think you can use it under certain circumstances,,will post when I am done checking my resources. Some hospitals will state a specific volume in their policies to cover all types of CVCs.

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i see. i though since there is an IV running it's okay not to flush. if the PICC line is not use i will for sure flush it before drawing blood. anyway thanks guys!

I know this is an old tread but isn't this wrong? I would think that if there was anything other than NS running it should be flushed. The OP said that this fluid had K+

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