Need help with Power PICCs

Specialties Infusion

Published

Hi all -

I'm a nurse at a snf, c a resident who has a purple PowerPicc, with clamps. He is receiving vanco thru it q12hrs. Today it clotted off and we sent him to the ER for CathFlo. In talking with the ER nurse tonight, she stated that they use +displacement valves, never clamp, and only use 10mls NS q8hrs to flush. Our policy and our pharmacy states that nonvalved caths need 5ccs NS and 5cc 10unit heparin to flush q12hrs.

What do most PICC nurses out there recommend?

Thanks -

iluvivt, BSN, RN

2,774 Posts

Specializes in Infusion Nursing, Home Health Infusion.

First of all you have to follow your facility protocol...a few hospitals and hospital systems have gotten rid of the use of heparin on some CVCs b/c of HIT (heparin induced thrombocytopenia..there is HIT 1 and HIT 2 )...even though it effects a very low percentage of the population. The manufacturers of most IV catheters will market their valved catheters as saline only flushes being OK......THIS DOES NOT mean that you cannot use heparin if your facility calls for it. Bard also makes a SOLO power picc that has valves in the tails...the one you describe is just a regular power picc with clamps ....if you do not have a positive displacement valve/cap ...you can perform a positive pressure flush....flush using a pulsatile push pause method......so push then pause and push again...and with your final flush when you get to the last 1/2 ml or so in he syringe keep pushing while is connecting the syringe....it takes a little practice.......you will see a little squirt of fluid if you are doing it correctly.....yes q 12 hrs is pretty standard...that is what we do...we use 10 ml NS then %o units of Heparin.....if you are doing blood draws you might want to add 10 more mls of NS and do your flushes right away after blood draws and as soon as medication administration is done.

iluvivt, BSN, RN

2,774 Posts

Specializes in Infusion Nursing, Home Health Infusion.

just wanted to add a correction...you need to disconnect the syringe from the cap while still flushing to get and end postive pressure flush

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