don't call me dumb...

SmilingBluEyes · Sep 10, 2008

I think this question should be moved to General Nursing for more participation and answers.

Mods?

Editorial Team / Admin · Sep 10, 2008

Thanks, Smiling.

Moved to General Nursing.

mama_d, BSN, RN · Sep 10, 2008

What is the diff in an EJ, IJ, triple lumen, central line, PICC and what are the most important things to know abaout them...I know they get heparin flushes and flush with positive pressure, but what else should I know

From my experience, others correct me if I'm off base:

EJ is external jugular (peripheral access), IJ is internal jugular (central access). At our facility only ED and ICU nurses place EJ's.

Central line indicates that it is arterial access, placed subclavian, jugular, or femoral. Triple lumen and quad lumen indicate the number of ports coming off of the end. Placed by docs.

PICC indicates a peripherally placed central line, usually just above the AC space although I've seen them higher. At our facility we have a vascular access team made up of RN's with specialized training who can place at the bedside, or they are placed in radiology.

We no longer use heparin flushes in general (although you want to with a port-a-cath, you just slurp out the heparin before using it again). Too many people have develped HIT (heparin induced thrombocytopenia). We pulse flush with saline instead on central lines/PICCs.

General PIV's can be placed by any nurse.

All of the above can be d/c'd by bedside nurse at my facility. Used to be they'd let the techs d/c PIV access but not anymore.

Always use sterile procedure when doing dressing changes on lines. We had a floor at my hospital where the incidence of line infection hit 25%!!!!!!!!!!!!! Totally inexcusable.

nrsang97, BSN, RN · Sep 10, 2008

Peripheral IV's are inserted by nursing staff and removed by nursing staff. A IV inserted in the EXTERNAL juggular vein is peripheral and inserted by EMS or a MD, however nursing staff can remove and insert if trained. I don't flush peripheral IV's with heparinized saline.

http://www.icufaqs.org/

The above like should help with the central lines.

PICC lines are inserted for long term therapy. Patients often go home with them. My SIL had to go home with one to run TPN. Usually are inserted by a trained RN or in interventional radiology. RN can remove. PICC lines can have 1-3 lumens. If it is a power PICC no need for heparin flushes.

I hope this helps. The site is kinda slow to open the info on central lines and PIV's. Be patient for it to open (or maybe it is just my computer).

nrsang97, BSN, RN · Sep 10, 2008

What is the diff in an EJ, IJ, triple lumen, central line, PICC and what are the most important things to know abaout them...I know they get heparin flushes and flush with positive pressure, but what else should I know
From my experience, others correct me if I'm off base:
EJ is external jugular (peripheral access), IJ is internal jugular (central access). At our facility only ED and ICU nurses place EJ's.
Central line indicates that it is arterial access, placed subclavian, jugular, or femoral. Triple lumen and quad lumen indicate the number of ports coming off of the end. Placed by docs.
PICC indicates a peripherally placed central line, usually just above the AC space although I've seen them higher. At our facility we have a vascular access team made up of RN's with specialized training who can place at the bedside, or they are placed in radiology.
We no longer use heparin flushes in general (although you want to with a port-a-cath, you just slurp out the heparin before using it again). Too many people have develped HIT (heparin induced thrombocytopenia). We pulse flush with saline instead on central lines/PICCs.
General PIV's can be placed by any nurse.
All of the above can be d/c'd by bedside nurse at my facility. Used to be they'd let the techs d/c PIV access but not anymore.
Always use sterile procedure when doing dressing changes on lines. We had a floor at my hospital where the incidence of line infection hit 25%!!!!!!!!!!!!! Totally inexcusable.

Central lines are venous access!

Piki · Sep 10, 2008

Central lines are venous access!

I was just going to say the same thing. Central lines are venous and you can run fluids, TPN, push meds (I shudder to think what would happen if you tried doing that with an art line).

1styearsucks · Sep 11, 2008

what comes to mind that i think is off importance is that all these lines have a riski of causing sepsis. especially, the ones that go into the central circulation(Hickman,hohn,grosshong these are central lines) they have a large risk of causing systemic infection. So the dressing changes need to be done q7 and the caps need to be changed frequenty.Also, dont leave the central lines unclamped and open to air, when the pt. takes a breath this air can go into central circulation causing an embolus. hope this helps, i could say more but these are the biggies. :nurse:

mama_d, BSN, RN · Sep 11, 2008

Crap, sorry, was tired when I was writing that...I was thinking about the fact that the catheter is so much longer than for an angio and misworded...you'd think I would have caught that after the first time I typed it!