Central Lines/Infus-a-port Questions

[BoyNurse07]

I need some insight on how you guys deal with central lines, infus-a-ports, and PICC Lines.

Blood draws: We flush with 10ml of normal saline, then draw back 10ml; then you pull back 5ml of waste; finally pulling back your sample.

Is this right? With TPN, we flush with 20ml prior.

Flushing: We still use Heparin with all of our ports and central lines, except for valve-ended PICC lines. We ususally flush everything with 10ml of normal saline then 5ml of Heparin Flush. This is with central lines and infusaports. We flush all unused ports-- every 8 hours and of course, before and after each use.

Dressing changes: We change our central line and infus-a-port dressing changes once a week or more if required. We clean first with betadine, then with alcohol. But, I think it should be the other way around but nobody thinks that I know what I am talking about.

Just curious of all of your thoughts.

[NRSKarenRN, BSN, RN]

Great reference:

CARE, USAGE, MAINTENANCE AND COMPLICATION MANAGEMENT OF CENTRAL VENOUS CATHETERS (CVC)

http://www.mededcon.com/cvc01.htm

[PICC chic]

Here at my facility, we do not heparinize any of our lines, strictly saline only with a good postive pressure cap. Our flushing protocol is flush with 10 ml, waste 3-5 mls of blood, sample then 10 ml NS flush.

With TPN, we stop it, flush with 20 mls, waste 10, draw sample.

Its always best not to draw your lab from the port that the TPN is running through.

As far as dressing changes, 24 hours after insertion then weekly and prn, chlorhexadine is a much effective cleaning agent then alcohol and betadine.

It is alcohol first, because it defats the skin surface. When you do it second all your doing is removing the betadine!