back up of blood into picc line..

Nurses General Nursing

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Hi I'm a new nurse and sorry didn't know where to post this either! But I had a pt with a picc line and a iv antibiotic was ordered so I primed n hung the bag. Everything seemed fine so I left the room n 10 min later the pump is going off n there is dried clotted blood in half the line. The picc wouldn't flush anymore.. so what did I do wrong?

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Specializes in Acute Care, Rehab, Palliative.

Did you flush it properly before you hung the bag? Or perhaps it wasn't heparinized after the last use.

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Specializes in Med/Surg, Academics.

Was the abx in a plastic collapsible bag or was it in a bottle that needed to be vented? During my first try at hanging albumin in a bottle to be vented, I did it wrong and it pulled blood into the line from a central line. Thank goodness a more experienced nurse helped me out.

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yes I flushed it at the beginning of the shift, flushed easily with blood return. Then, I hung the bag later and it flushed with blood return again. I work at a nursing home btw, so I cant really answer these questions. I had to send the pt out but she returned later and the night nurse hung the bag.. and everything went fine. Its a nursing home so they don't have the best pumps, I just feel like the worst nurse right now. I've hung antibiotics before and this has never happened.. The emt thought her bp was high but her bp was 130/70, but I've read that blood reflux can happen if the bag isnt high enough.. idk

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I wouldn't beat myself up. The ED probably just flushed the line and sent the patient back. Things happen.

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Specializes in Vascular Access.

Well, in 99.9% of the cases where I see this happening to nurses is when they do NOT thread the tubing into the pump appropriately.

Take for instance the Flogard 6201 series pump, it will let you erroneously thread the tubing in upside down, and you'll know when this happens because blood will be sucked out of their vascular system and up the IV tubing. Remember, in this case, what comes off of the top of the pump door, MUST go to the IV bag and not the patient. If it goes to the patient, you have the tubing in backwards.

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Hmm.. i don't really think the tubing was backwards bc the pump only let's u lock the tubing into place one way. It won't lock into place if the tubing is upside down I tried doing that when I was trained. But that's the only logical answer why blood reflux occurred but I really don't think it was backwards ugh

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But would too much tubing being left out from the pump that goes to the iv site/pt cause blood reflux?

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Specializes in Vascular Access.

What pump are you working with? Name brand please.

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