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Discussion

Flush question with double Lumen

I am a home health nurse and did an ABT infusion on a client this afternoon. He has a double lumen picc line. The order is the same for the infusion like using sash,and dsg change q 7 days or as needed. There are no orders to flush the other lumen that I can see and we always flush them with ns then with hep QD in the hospital????

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Hmm, that could be a problem. The second lumen might not be patent when it's needed... and I'd assume there was some reason it might be needed or they wouldn't have put in a double lumen. Maybe the other nurses ahve been alternating lumens when they give their meds so that both lumens are being saline flushed regularly. There are some studies that suggest that heparin isn't needed to maintain patency.

Our flushing protocol covers any line, no matter how many lumens, they are all treated the same.

You absolutely need to flush that other lumen with the same flush solution and frequency that you would the one you are using. So if your agency has a daily flush the patient or carfegiver needs to be instucted to do so. Not only is there the issue of dysfunction (that lumen will not work if needed) if it occludes with blood ,it puts the patient at an increased risk for infection. It is the standard of care to treat persistant withdrawl occlusions (able to instill but not withdraw) with Tpa/ Alot of nurses do not realize that. Bacteria love blood so they will proliferate there where there is a good food source. Hope this helps.

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