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Drawing blood from a PICC line

Nurses   (47,749 Views 37 Comments)
by rnewmanjunkie rnewmanjunkie (New Member) New Member

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Is there a better way to draw blood samples from a PICC line other than drawing the sample in a syringe and transfering it to a vacutainer tube? Thanks......

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21,296 Visitors; 6,487 Posts

Not really. Vacutainer tubes create too much suction. Best way to do it is to use a small syringe, no more than 5 ml. You will have to use several syringes but it's better than losing the line. This would not make the pt or his doctor happy.

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brent_25 has 9 years experience and specializes in Med/Surg, IV therapy, Emerg, Peds.

1,318 Visitors; 20 Posts

I have drawn blood from PICC's for years on an IV team - and we always use vacutainers - and have no problems. A syringe actually creates more pressure than the vacutainer we find - we will use a syringe when the blood will not come vacutainer method. For these times we have a syringe transfer vacutainer so we don't have to add a needle to the syringe to perform the transfer.

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All_Smiles_RN specializes in Cardiology.

5,982 Visitors; 527 Posts

I always use the vacutainer that connects directly to the picc. Works fine for me.

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1,092 Visitors; 8 Posts

i use a vacutainer, or a 10 or 12 cc needless syringe. the smaller syringes exert too much pressure and can collapse the line. :o

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1,933 Visitors; 80 Posts

One of the first things I learned on the floor was to never ever use less than a 10cc syringe to draw blood from a PICC line.

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CritterLover is a BSN, RN and specializes in ER, ICU, Infusion.

11,290 Visitors; 872 Posts

not really. vacutainer tubes create too much suction. best way to do it is to use a small syringe, no more than 5 ml. you will have to use several syringes but it's better than losing the line. this would not make the pt or his doctor happy.

no, the smaller syringes exert more pressure, not less. use a large syringe, no less than a 5cc (our facility allows piccs to be flushed with 5cc syringes. other facilitiess may require a 10, just depends on their policy).

vaccutainers exert less pressure than a 10 cc syringe, so they are safe to use with piccs. i've never found them very effective, though.

personally, i draw the blood in a 10 cc syringe, and instead of using a needle to do the transfer to the blood tube, i take the tops off of the tubes and squirt the blood (the tube tells you how much blood they require) straight from the syringe to the tube. no needle involve, so no risk of getting stuck.

one problem with this method: with the light blue tops we use, i sometimes have a hard time getting the tops back on securely. so i'll wrap them with parafilm before i tube them to the lab.

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RedCell specializes in CRNA.

8,236 Visitors; 436 Posts

Pressure is equal to force/area. A 3ml or 5ml syringe has a smaller area and therefore has a greater pressure than a 10ml syringe. The 10ml gimmick is more appropriate for the PICC lines.

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lsyorke specializes in Med-Surg, Wound Care.

6,793 Visitors; 710 Posts

Our PICC team does all blood draws from PICC lines. They always use vacutainers.

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zacarias has 14 years experience and specializes in tele, stepdown/PCU, med/surg.

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one big thing is you NEVER directly attach blood culture bottle to the picc. The culture medium in the bottle is deadly if it gets into blood stream.

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bleppity specializes in Adult Hematology/Oncology.

2,698 Visitors; 55 Posts

I didn't know you could hook a vacutainer directly to a picc line. How does this work?? Do you use the vacutainer transfer device to do it? I'm having trouble visualizing this one. At my facility, you use a 10cc syringe and you have to waste the 1st 10cc syringe (unless you're drawing blood for blood cultures).

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902 Visitors; 14 Posts

You never want to "pop the top" off of a vacutainer tube. If you let the vacuum draw the sample from the syringe, then you get the proper amount of blood to anticoagulant and remove the dilutional factor. Coagulation tubes MUST be filled properly or the results are invalid. Also, when you remove the stopper, the stopper can come in transport contaminating an entire transport system.

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