PICCs

  1. 0
    Do you have to use a separate syringe for each lumen on a multi-lumen PICC (as in 3 NS prefill syringes, and 3 heparin prefill syringes if flushing a triple-lumen PICC) and, if so, why?
    Also, if you're just doing the routine flush (no meds), do you need to flush with NS first, or just heparin?
    I've seen too many variations in this process, and nobody on my floor can give me a clear answer on this.
    Thanks.
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  3. 8 Comments so far...

  4. 0
    Sorry I can't answer your question cause I also feel the same way. I am not in a hospital but I think if I was I would contact the IV team if that is what your hospitals uses and ask them directly. They would know. Let me know if you find out. For some weird reason I thought heparin was no longer used.
  5. 0
    you should use a different syringe for each port d/t cross contamination and by the way, PICCs and other central access lines should only be used with a 10cc syringe d/t distance trqveling in the catheter and also d/t pressure in the lumen.
  6. 0
    I bet you could find the policy for your hospital on their website. (the one for employees). I am confused about this too so I have to look up my hospitals policy. I don't understand when you are supposed to flush with 30cc and when you flush with 300cc. We also use the SASH (saline-admin med-saline-heparin) method at our hospital after every medication.
  7. 0
    We use different syringes (10cc's only) for each port (risk of cross contamination as mentioned above). We flush PiCC lines (that are not in use) only with NS and only once a week (additional heparin is required for the close-ended type- we do not have them anymore). Check the hospital policy because this is what you should be following.
  8. 0
    YES everyone is correct you need to use a different syringe for each port.....A syringe should only be used once unless it is set up on a sterile field and used in a sterile fashion....some hospitals choose to use only NS for flushing CVCs or certain kinds of CVCs and PICCs (Valved ones such as the groshong...solo and PASV)...if your hospital uses Heparin...yes you should be doing the NS first then the Heparin in whatever strength their policy says. All CVVs should be flushed using a pulsatile push pause method....and IF you have a negative displacement type cap.you need to perform end postive pressure at the end of the flush...ask the IV nurses what kind of cap you are using!!!!..ALL PICCS require the use of a 10 cc syringe as each has a certain PSI..that you do not want to exceed..which is possible with the use of smaller syringes...the catheter may develop a pinpoint hole or fracture and then there may be complications and/or will need to be removed. A pinpoint hole could cause any medication to leak out and the patient will often c/o pain (usually n the arm) during medication administration. the other times I often see holes or fractures is with the improper instillation of TPA...the bottom line is NEVER force it...if you do not know how to work it in (yes there is a way).....wait for someone else to show you or do it....ia PICC nurse would rather instill Tpa...then have to replace the line
  9. 0
    Quote from creo
    We use different syringes (10cc's only) for each port (risk of cross contamination as mentioned above). We flush PiCC lines (that are not in use) only with NS and only once a week (additional heparin is required for the close-ended type- we do not have them anymore). Check the hospital policy because this is what you should be following.
    Sorry, I meant to say that heparin is used for the open-ended PICC's
  10. 0
    The Infusion Nurse Society recommends using different syringe and to flush before and after with NS always. I think the different syringes has to do with infection control. The NS is to prevent too much heparin being used.
  11. 0
    At our hospital we flush unused PICC ports Qshift with 20 ml of NS and 5 ml of Heplock flush. We scrub them with alcohol before attaching the syringes so it's not necessary to used different syringes. And of course we always flush with NS before and after meds bcuz heparin is incompatable with a lot of meds.


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