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TPN should always be a dedicated lumen. So if you only have a SL (single lumen) you should not be administering anything else in that lumen. If you have a dual lumen or a triple lumen PICC then you can use one of the other lumen(s) and leave the TPN or TPN and lipids (whatever the case) infusing.
If this is a SL the best course of action is to start a PIV. Then if you need a multi-lumen PICC you can address that as well.
If there is only a single lumen picc I pause the ton do 2-3 flushes, the med(s) and then 2-3 more flushes. If there are lipids running I do not put anything in the line without checking with our pharmacists. Hope this helps!!!
We generally have the PICC (if single lumen) dedicated to the TPN and a peripheral line for medications. Ideally a multi-lumen PICC is the best-case scenario. In absence of same, a peripheral site is the best choice.
I would see about starting a peripheral line for medications or if that is not an option, consult pharmacy.
Usually I've found it's okay to do a flush, run the med, flush, then restart the line. But if they have a lot of meds (ie. Antibiotics, etc) we collaborate with the RD to alter the TPN/lipid rate to compensate for the lost TPN infusion time (increase the TPN rate as it will only run maybe 20 hours total).