Blood return on Picc Line

[billydunwoody]

My father has a picc line, and a nurse to draw blood weekly, get antibioic invanz daily, and vancomycin every 48 hours. Today, she drew the blood, hooked up the invanz, and after invanz hooked up the vancomycin. She taught us(and from past picc line experieces) how to remove the tubing when its done, and how to flush. However, 30 minutes into the Vancomycin, there is blood coming out of the picc line, like it wants to go into the iv bag, almost 12 inches of blood can be seen in the tubing. Eventually the flow of the antibiotic pushes it back through the picc line, but I was wondering, is this normal? This also happened last week.

[Asystole RN]

Yes. Coughing, movement etc can cause a sudden spike in blood pressure that will do this, no harm no foul. Ask your home health nurse for valved tubing, this will prevent that if you are concerned. Also, dropping the bag to a too low of a level (height) may cause reflux too.

[IVRUS, BSN, RN]

My father has a picc line, and a nurse to draw blood weekly, get antibioic invanz daily, and vancomycin every 48 hours. Today, she drew the blood, hooked up the invanz, and after invanz hooked up the vancomycin. She taught us(and from past picc line experieces) how to remove the tubing when its done, and how to flush. However, 30 minutes into the Vancomycin, there is blood coming out of the picc line, like it wants to go into the iv bag, almost 12 inches of blood can be seen in the tubing. Eventually the flow of the antibiotic pushes it back through the picc line, but I was wondering, is this normal? This also happened last week.

When this occurred, was your father up walking around? Also, is this being run in the PICC via a pump?

If it is a gravity infusion, and your father is walking around, make sure he is doing so with his arm folded to his chest to prevent reflux. Since Vanco has a unique syndrome when it's infused too quickly, it should be ran on a pump. In addition, gravity flow is usually not sufficient to get the flow you need when infusing through a PICC, so a pump again is indicated. Because of the long length of the PICC, resistance is created. Infusing via pump aids in getting the medication into the patient.

[annaedRN, RN]

Most Vanco in the home is administered in elastrometric therapy (Eclipse or Intermate) - atleast most of the time. Or a portable IV pump such as the CADD Prism pump - usually no IV poles required