Is this ok?

[RachelRN2011]

I am new to home health and previously work in a environment where there was very little central line access, so my experience is limited to say the least. Anyway, I am going to access an i port in the am and need to draw a bmp,cbc and a pt/inr. After accessing the port and getting blood return I will flush with 10cc ns then draw off 20cc, then draw labs flush with 10 and then flush with my heparin. My question is... Can I place a vacutainer onto the tubing to draw my labs? is this too much pressure to have onto the port? Just curious and I want to do everything appropriately!! thank u!

[Isabelle49]

I've never done that, only drawn with a syringe then placed in vcutainer. Pressure may well be too much for the catheter...

[kat7464]

When in doubt check your policy and procedure manual. The way we do it is to flush with 5 cc SNS, draw/waste 5 cc, draw enough for specimen, flush with 20 cc SNS. We only use heparin on power piccs for the most part, and then very small amounts.

[JessLPN2RNASN]

A port is a little different than a PICC line but the technique is the same. Clean the site well, flush with 5-10 ml NS and waste 8-12 ml, draw your labs with a syringe and transfer to the tubes. Flush with 10 ml NS and 5ml heparin EVERY TIME. If heparin doesn't sit in the port reservoir blood clots will form and the port will have to be replaced. Very expensive and will always be documented as poor nursing care. Heparin will not dissolve a clot, so if you don't flush and then try to fix the problem by using heparin you wont have any good outcomes. Always flush first, waste more than you flushed with, flush again, and don't use anything you can't control the pressure of to draw blood out. Remember these devices are in fragile bodies and the vessels may not tolerate excessive pressures. Ports aren't foolproof and shouldn't be considered indestructible. It is especially important to waste more if drawing a PT/INR because the heparin left from the prior draw will affect the lab value. It is actually best to draw this one from a peripheral vein.