No blood return from PICC...is it a problem??

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I'm in home health and have a pt who recently had a PICC inserted for IV ABX infusion d/t osteomylitis. I tried drawing labs from PICC (singe lumen) but was unsuccessful. I was able to get less than 1cc of blood. His IV ABX infuses with no problems. Should I be concern? Are there tips to try to get blood return from PICC (e.g arm positioning)?

Specializes in Vascular Access.
iluvivt said:
IVRUS is correct..I was just going to say what was said. If a mechanical issue has been ruled out it is most likely a persistent withdrawal occlusion (can easily instill but no blood return obtained) and should be treated with Tpa (cathflo). if it is a complete occlusion a drug or mineral precipitate needs to be considered as well.

OH MY GOSH... I have MISSED YOU GIRL.... So good to see you back!

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Specializes in Infusion Nursing, Home Health Infusion.

IVRUS....... So busy getting my daughter through her first year of high school...she is doing on- line high school with me as her learning coach. I have retaken the CRNI test again and have been studying all things IV..placing PICCs with ECK technology. I will PM you bcause I really would love to have your opinion on a CVC problem that we are having that is really beginning to annoy me..would that be OK?

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Specializes in Vascular Access.

Anytime... It is so good to know that you are okay. PM me anytime.

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Specializes in Paediatric, oncology, AOD nursing.

With respect to home care nurses, The INS 2011 (http://www.rcn.org.uk/__data/assets/pdf_file/0005/78593/002179.pdf, p.83)has an algorithm pertaining to persistent withdrawal conclusion strategies. However I strongly agree with the other posts that suggest investigating this issue further and the need for tPa, a line-o-gram etc to confirm that correct tip location.

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I was recently in a chemo unit where there policy was to do the normal tilt head lay patient down but found that they do a fluid challenge then give IV dexamethazone antisickness if they can feel the tingling in there bottom it was ok to use!!!!!This not a good procedure or practice and unsafe. What should have happened at the least a CXR to see placement of line. There should be strict guidelines in place across the UK so this does not happen. Thank you needed to share

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