We give IV push meds all the time. So for example 4mg of morphine=1ml. We push this through a PICC over 1 minute. since the catheter is so long aren't we really just pushing it slowly though a small length of the catheter? Then we flush w/10cc NS-but isnt the flush really what will push the med though-should we be flushing over a minute as well?
Also if you are pushing through a running IV, if you pinch the line, arent you just injecting his thru the length of the tubing-isn't the med not really infusing until the running IVF is infusing??
Is the definition of a PICC line, namely Peripherally Inserted Central Catheter the same as Percutaneously Inserted Central Catheter? Also when we flush the PICC,line we use 2ml normal saline followed by 1ml heparin (at 11U/ml), and we flush the Midline Catheters with 5-10 ml normal saline followed by 1 ml heparin (at 100U/ml)? Thanks.
A percutaneous inserted IV cathter isn't necessarily the same as a PICC. The triple lumen catheters that MD's place with the entry into the subclavian, and then threading down to SVC, or in reality called a Percutaneously Placed, Non-tunnelled TLC. Percutaneous means through the skin and while both of these catheters go thru the skin, only one is placed in the peripherally, or in the extremity.
I am not familar with any Heparin flush concentration of 11units/ml (perhaps it was a typo). I am aware of 10units/ml and 100units/ml, etc. I do find it curious that you are flushing PICC's with a final 10units/ml herarin and Midlines with a greater concentration of 100units/ml. It is usually the other way around.
Thank you IVRUS, I am actually not doing it, but rather reading from a book about it. In the hospital I was told to flush peripherally inserted catheters with 10cc NS before and after meds, and to flush the PICC lines with 10 cc NS followed by 5cc heparin.
Clinical question for any NICU RN's. Baby was on TPN/IL, Veceronium, Versed, and Morphine. The night nurse endorsed she was giving all the IV meds through the same PICC. Wouldn't this have been a bolus of all the gtts? Any thought?
In my hospital it is policy to dilute morphine before iv push.....so i put the 1ml of morphine right into a 10cc flush and push that over 2 min. then flush with 5cc flush slowly...
You are correct the patient is not going to recieve all the medicine until you flush the line if there are no running ivs. I agree with others and say dilute everything.
WhiteLily
15 Posts
Is the definition of a PICC line, namely Peripherally Inserted Central Catheter the same as Percutaneously Inserted Central Catheter? Also when we flush the PICC,line we use 2ml normal saline followed by 1ml heparin (at 11U/ml), and we flush the Midline Catheters with 5-10 ml normal saline followed by 1 ml heparin (at 100U/ml)? Thanks.