Drawing blood from power picc

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Specializes in cardiac/critical care/ informatics.

I witnessed this the other day and wondered if it was appropriate. Nurse drawing blood from Power Picc, cap off, syringe to end, when she took off syringe to get another she didn't clamp the line. I know with a central line you wouldn't do this, so should that be done with a Picc? My concern is with an air embolism.

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Specializes in LTC, ER.

what is a power picc, and how does it differ from a regualr picc?

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Specializes in cardiac/critical care/ informatics.
what is a power picc, and how does it differ from a regualr picc?

It can withstand the pressure of an injector like what they use to inject contrast with in radiology for ct scans etc. And they are purple so you know that it is a power picc.

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Never mind, I answered as though the pt had an implanted port, not a PICC.

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There is a new PICC on the market that doesn't have any clamps because it has internal valves that act as clamps and it is power injectable and also purple. It is the practice at my hospital when the nurses MUST use the line for lab draws they should leave the injection cap on, draw labs with a syringe, flush with 20ml NSS and then change cap(s).

BEWARE: Not all power injectable PICCs are purple but all are labeled

near the extension legs.:typing

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Specializes in ER, ICU, Infusion, peds, informatics.

while what you describe is not "proper," given the long length of a picc and that the open end is most likely below the level of the heart, the chances of an air embolism are pretty low, close to non-existent.

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CritterLover, I wasn't referring to air embolism issue. I thought we put the injection caps on for sterility rationale. I wouldn't want my open ended PICC laying in wound drainage, sputum,etc....

I agree with you the risk of air embolism is almost non-existant!

Karen:nurse:

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Specializes in Acute Care Cardiac, Education, Prof Practice.

When I worked at a rural hospital we drew our PICC labs. We removed the cap because the theory was that the blood could possibly be damaged by pulling it through the mechanism of the cap.

However we clamped anytime there wasn't a syringe or cap on, we did not let the open end of the PICC hit anything, and we applied a flushed sterile cap at the end of the draw.

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Specializes in ER, ICU, Infusion, peds, informatics.
critterlover, i wasn't referring to air embolism issue. i thought we put the injection caps on for sterility rationale. i wouldn't want my open ended picc laying in wound drainage, sputum,etc....

i agree with you the risk of air embolism is almost non-existant!

karen:nurse:

right -- but the op's concern was air embolism, and that is what i was addressing.

i used to place boston scientific pasv piccs, and would leave the injection caps off until just before i took down the sterile field. it used to freak people out because of the air embolism issue, which was a non-issue. first, it was a valved picc; and second, the insertion site is below the heart. infection wasn't an issue since the sterile field was still intact.

for those who d/c picc lines: this (the insertion site being below the level of the heart, and the long length of the picc => practically no chance of an air embolism) is why you do not need to have the patient in trendeleberg when you pull a picc. they don't have to do the valsava maneuver, either.

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Specializes in ICU.

it takes about 30cc's or more of air injected into a vascular system to do real damage. chances of air emboli from caps off piccs are nil, however, on a sterility front, caps off is just not done, risk of infection is far to great to mess with!

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