PICC and Blood transfusion

[brittkay70]

Hi there- Just have a question....I am a new grad nurse and I got into a rather heated discussion yesterday with a more experienced RN about the way in which I handled my patients blood transfusion...could someone help set me straight?

I work on a cardiac stepdown unit and my 64 y/o pt with no previous cardiac hx needed 2 units of PRBC and 4 units of FFP. She had a double lumen PICC and a 20gauge heplock in her hand. I chose to run the blood through the PICC and the use her heplock for the 10ml of Cardizem and ???ml of dilaudid she was getting from a PCA pump. I shut off her maintenance fluid until after the transfusion.

The more experienced RN said I could have used the PICC line for both the blood and the meds by running the meds through one port and the blood through another. I think she is right IF the line had been a Central Line but because a PICC has a much longer catheter I was worried about the mixing of the blood with the meds on the ride to the SVC??? For future knowledge can anyone please clarify this for me???? thanks - britt

[RNladybug26]

In double lumen PICC the 2 lumens are actually separate, so you can infuse incompatible drugs through them, similarliy to a central line. So while they are "riding" to the SVC they are not mixing. A PICC (peripherally insterted CENTRAL catheter) should be centrally located in the SVC. You can check the radiologists confirmation of placement on the CXR. You were not "wrong" in using the saline lock, but there are less complications when infusing through a central line because of increased blood flow. Hop ethis helps. :)

[SWAT_RN]

:yeahthat: Remember, it's still a central line, so you treat it as you would a triple l etc.