Drawing Blood From PICC Lines

OC_An Khe · Mar 8, 2003

Is this the MD's preference known to the staff, or is it written as order on patients chart?

Home Health Columnist / Guide · Mar 8, 2003

Agree with above posters: Lab draws can be done on any PICC

4 FR or greater using 10cc syringe. Purpose of PICC is to SAVE VEINS!

From Bard--manufacturer

QUESTION: What syringe size is recommended for use with various catheters?

ANSWER: It is recommended that a 10cc syringe or larger be used to infuse or flush catheters. This includes Pediatric and neonatal catheters. Infusion pressures should never exceed 25 psi because pressures higher than that may damage blood vessels and viscus. A two-pound weight equivalent force on the barrel of a 3cc syringe generates pressure in excess of 25 psi. The same two-pound weight equivalent force on the barrel of a 10cc syringe generates less then 8 psi of pressure. Please refer to the Instructions for Use for further details.

More info here:

https://www.bd.com/en-us/products-and-solutions/solutions/vascular-access-management

Venous access ports:

https://www.cirse.org/patients/ir-procedures/venous-access-ports/

Patient advocacy alert!!

Sounds like many nurses need to check with the manufacturer of IV device being used in their facility for education on devices and use to discuss concerns with prescribing doctors and creating up-to-date policy and procedures!

jemb · Mar 8, 2003

Tory, I just want to approach your question from a different angle here. From some of your previous postings, it is obvious that your employer is very lax about training. My guess is that the docs are not wanting blood to be drawn from PICC lines on their patients because of a history of the lines becoming clotted or having ither problems after blood draws have been done by inadequately oriented/trained staff.

It should not be a problem to do blood draws and maintain the line. But when there is either no policy guideline in the facility or this information is not available and taught so that the procedure can be uniformly practiced by all the nurses on the unit, problems can and will result.

KailuaNurse · Mar 8, 2003

At my facility we are allowed to draw labs from PICC lines as long as they are a 3 fr or bigger. This is great for the pediatric population since it means that they don't need to experience another poke

BrandieRNq · Mar 8, 2003

My facility has recently added prefilled saline syringes to our supplies in 5cc and 10cc sizes. I can't remember the company they are from. The interesting part is that the barrel of the 5 cc syringe is the same diameter of the standard 10cc syringe which means the pressure is supposed to be the same that would be exerted by the 10cc syringe. We do draw from PICC's routinely.

fancynancy · Mar 10, 2003

"look it up" check out the website for the PICC manufacturer, read their guidelines for use. compare it with your nursing policy and procedures. Make use of the websites that are reliable, the Intravenous Nurse Associations have a list of good websites. oh! be sure to note the last time your policies and procedures were up dated. check their references and how recent the references are. What You do is What you get.

BuffaloLPN · Apr 21, 2003

this might sound dumb, but maybe you're not alllowed to draw because it would affect test results? I am thinking that in some cases, no matter how much waste is drawn, certain things (lipids for ex) would alter labs anyway. It seems like we poke kids for peak and troughs all the time, and they all have piccs or mediports.

JenMarie · Apr 21, 2003

We take bloods from PICCs using similar protocols as discussed as above. However we are told it depends what size the PICC is. Only able to use it for blood draws if it is greater thatn a size 3 french. If it is smaller than that we always have to have fluids running...which is a real pain for the patient being attached to fluids the whole of their hosp stay.

jadednurse · Apr 21, 2003

Quote

Originally posted by Tory
... Some RN's abide by this and have lab stick the patient for labs. Other RN's draw blood from the PICC reason being,....they don't have any veins to begin with (which is why they have the PICC). I would like to get your opinion on this. I am a fairly new grad and have made waves with this. I used to draw blood from them until I learned the drs said not to. So now I refuse to do it and have lab do it (often times they are unable to get enough blood or can't find a good vein). Just curious. Thanks!

Is it like this with other procedures on your unit...I mean doesn't anyone follow a protocol, or do they all just "do their own thing?" If the protocol for any procedure isn't clear, is their a unit or nursing educator at your instituion whose job it is to review this sort of thing? Have you discussed it with your manager?

Jay-Jay, RN · Apr 22, 2003

Quote

Originally posted by Sleepyeyes
We are not allowed to draw from a PICC when the pt has a heparin gtt, for obvious reasons.

Why not? The reason isn't obvious to me! I would think you would not want to do a peripheral draw on a pt. receiving heparin, because they are much more likely to bleed from the puncture site and get a hematoma!

Of course, you would have to disconnect the drip to do the draw, flush pre and post, then reconnect. That would keep the heparin from contaminating the sample(s) drawn.

In the community we use heparin for 2 things 1) Hepalean is used to flush central lines (usually 10 cc NS, then 3 cc Hepalean) and 2) Fragmin (low molecular wt. heparin) is given to pts. with DVT's by s.c. injection. We don't do heparin drips, so maybe there's something I don't know here....

amk1964 · Apr 28, 2003

i've inserted a few picc lines and do use them to draw blood with 10 cc syringe; BUT the problem i've noticed is other nurses aren't heparinizing the lines after draws. this is important with small lumen caths. i've noticed younger nurses seem to think heparin flush solutions are dangerous. they are misimformed by misimformed teachers. SASH used to be the norm and was and is effective, but hospitals have switched to ns flushes only for the primary purpose of cost-savings. sure are alot of clooted lines these days?????

amk1964 · Apr 28, 2003

i've inserted a few picc lines and do use them to draw blood with 10 cc syringe; BUT the problem i've noticed is other nurses aren't heparinizing the lines after draws. this is important with small lumen caths. i've noticed younger nurses seem to think heparin flush solutions are dangerous. they are misimformed by misimformed teachers. SASH used to be the norm and was and is effective, but hospitals have switched to ns flushes only for the primary purpose of cost-savings. sure are alot of clooted lines these days?????