Policy development: Central lines

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  1. This is a discussion on Policy development: Central lines in MICU / SICU Nursing, part of Critical Care Nursing ... Sitting on a policy and procedure committee. Do you have a limit on the number of days a central...

    by Feb 24, '11
    Sitting on a policy and procedure committee. Do you have a limit on the number of days a central line can remain in place? Care to share some evidence used to support this decision? Thanks for your input!
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    by aCRNAhopeful Feb 24, '11 3:50 pm
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  3. 18 Comments so far...

  4. Feb 24, '11 by
    I don't have any evidence off hand, but our policy is every 7 days the site must be changed. However, if it's a groin line I believe the max is either 24 or 48 hrs.
  5. Feb 24, '11 by
    No time limit here. They usually end up coming out if there's a fever of unknown origin and a culture comes back positive through the line and not a peripheral stick.

    Dressing changes are at least every 7 days. Fem sites always seem to get filthy easily, they really should have a time limit.
  6. Feb 24, '11 by
    No set time limit on line sites. If we suspect they are infected we do a new stick. Femoral lines we try to get out in 24 hours or less....just depends on how bad we really need that line.
  7. Feb 25, '11 by
    Hi folks, need your input. I am an instructor in a nursing program and there seems to be some confusion concerning size of syringe when giving a med through a central/PICC line. 10 cc we know if you are using capped line...but what if you are administering through the Y site farther back from the cap (continuous IV infusing)..what size syringe..still a 10? I thought I read a couple of years back that you could use a 3 cc syringe of med only at the Y site....but of course, don't know where I read that.
  8. Feb 25, '11 by
    Quote from PreemieNurse
    Hi folks, need your input. I am an instructor in a nursing program and there seems to be some confusion concerning size of syringe when giving a med through a central/PICC line. 10 cc we know if you are using capped line...but what if you are administering through the Y site farther back from the cap (continuous IV infusing)..what size syringe..still a 10? I thought I read a couple of years back that you could use a 3 cc syringe of med only at the Y site....but of course, don't know where I read that.
    It's medicine, it doesn't care what size syringe it's in, it's still gonna do the same job.
  9. Feb 26, '11 by
    Quote from detroitdano
    It's medicine, it doesn't care what size syringe it's in, it's still gonna do the same job.
    I think its the pressure that a 3 cc syringe causes that causes concern, but I dont really know if it matteres anymore these days. Most piccs are power piccs and can handle it and you can push IV contrast under pressure ect,, and central lines are capeable of tolerating it I think, but the rationale we had in nursing school a few years ago was that 3 cc causes too much pressure. The wider 10 cc syringes are supposed to be better.
  10. Mar 1, '11 by
    That is what is being practiced in this area. The 3cc syringes exert too much PSI on the tip of the catheter and can actually tear the tip off, causing it to end up in the circulation. Not a good thing. 10cc much lower PSI, which is why they are being used and why we continue to teach that practice.
  11. Mar 1, '11 by
    We put our meds on a pump, some of our meds come in under 1ml so we don't have a choice but to use that syringe. But we always flush with a 10ml syringe because of the lower PSI.
  12. Mar 1, '11 by
    Quote from PreemieNurse
    That is what is being practiced in this area. The 3cc syringes exert too much PSI on the tip of the catheter and can actually tear the tip off, causing it to end up in the circulation. Not a good thing. 10cc much lower PSI, which is why they are being used and why we continue to teach that practice.
    So how do you give 2 mg of Haldol, 10 mg Hydralazine, etc.? The doses are less than an mL. Draw it up in a heparin syringe and shoot it into a 10 mL syringe?