Pediatric PICC lines

[UK2USA]

Hi all, I am looking for some info regarding common practice with Peds PICC lines. We are in the process of writing a practice guideline for heplocking a PICC.

Q1. Do you heplock a 1.9/ 3 Fr PICC in your hospital? Or do you maintain a KVO?

Q2. If you KVO... do you use a heparinized solution?

Thanks everybody.

[TazziRN, RN]

If a kid with a PICC is admitted, they're probably sick enough to need fluids. And I have hung plain NS via PICCs.

[vrhodes]

We hep lock their PICC's, it lets them get up and about, rather than lying in bed in their room all day.

[OzNurse69]

KVO with hep saline.

I'm in NICU though, so our kids aren't up to walking around!

[caringforlife]

We hep lock our pediatric PICC's according to weight. I always have to check the chart, but I think that it is 35kg is 3 ml of 100u/ml. We sometimes will leave it KVO if they have lots of antibiotics, but usually it is hep locked so they can get up and move.

[AliRae]

Depends on how sick they are ... I work PICU, so most of our kiddos aren't dancing jigs and they're probably getting a slew of IV meds. They get 3ml NS through each port for a KVO. (Big kids I sometimes use 5/hr just to make my own math a little easier!)

When we heplock a PICC or a port (or any other central line) it gets done based on weight. I believe our weight cutoff is 10 kg. Less than 10kg we use 10u/ml heparin, above that we use 100u/ml. We flush with 5ml NS then instill 2.5ml of the appropriate heparin and clamp the sucker off.

[wooh, BSN, RN]

Pretty similar to above on the heplocking (I always have to look up the policy when I do it though, can never remember if it's the 10 or the 100 and how much to use.) We heplock all the time so the kids can be up and moving. Although, we do try to keep something going KVO if they're getting a lot of antibiotics or other things IV, just so we don't have to do all the flushing and heplocking with each one.

[bsunurse]

I work in PICU and we do not use Heparin unless there is an order for it. We use positive pressure saline lock or kvo with normal saline at 3ml/hr.

[lovemyjob]

we do not allow heplocking of PICCS. Must be KVO w/ at least 1:1 heparin. Our PICC nurses say there is an increased risk of a clot forming around the outside of the catheter sort of like what can happen with a UAV/UVC when u go to take it out. That is why we run KVO.

[evaruth]

I Would Like To Know If Anyone Has A Web Site I Can Go To Get Inforamation On Port A Caths.