I have a home care patient who recently had a picc placed at a local hospital for ivf 3x week. After researching and looking at his picc (2 ports no clamps) I'm assuming his picc is valved. He has been getting D51/2 NS 1L 3x week via gravity for months via 24g piv until we were no longer able to get access. Previously a L would run in less than 2 hours free flowing by gravity. Now with the picc 1L is taking over 4 hours to run "wide open" by gravity!!! Does it have anything to do with this type of PICC? Any suggestions??? Nothing else has changed..same pole, same height, etc. I changed the dressing on the picc to check for kinks, occlusion etc to no avail. It's a brand new picc with great blood return and flushes with ease..
What kind of primary tubing are you using? If it the type you dial in a rate I would suggest you switch to a standard primary tubing. Next, do you have a tall IV pole as the height of an IV bag from the IV must be a minimum of 3 feet but if you can get it a bit higher that will help as well. Is it a Bard SOLO PICC you are using? If all of these fail you can switch to using a pump which any good home health agency should have.
It could be the needleless connector you are using?
Thanks for your reply. It's standard primary tubing sent by iv company. No dial a flow or anything attached. It's on a tall pole. Worked critical care before coming to home care so pretty familiar with the basics. It's just something with this picc I believe. I'm used to the clamped power piccs but this picc has no clamps etc. getting pump today. Hopefully will resolve my issues!
Also remember a PICC is much longer than a PIV so there will be more resistance with the gravity flow. A regular PIV may only be a couple of cm long but a PICC can be quite long up to 55cm depending on the size of the patient. The 5fr Bard Solo, each lumen will be 18g but gravity flow will be slower than an 18g PIV.