PICC line flush after blood draw

[Mizdeb123]

Should a PICC line port be flushed with heparin after ever blood draw?

[Castiela]

It really depends on your hospital policy and the type of picc catheters you use. Our facility uses closed ended and our policy is to flush with 20ml NS after accessing. However,we don't use heparin for our open ended cvcs either, again just flushing with 20ml NS

[LovingLife123]

We don't flush with Heparin. Flush with NS.

[AJJKRN]

Your policy should also include changing the cap to after every blood draw, TPN, every so many days, etc

[KelRN215, BSN, RN]

This has been the policy everywhere I've ever worked. You flush with saline, withdraw your waste, draw your sample, flush with saline, lock with 10u/mL heparin.

[Wuzzie]

1. Non-valved lines get flushed with saline and locked with heparin 100u/ml. The alternative is flushing with saline daily.

2. Valved lines get flushed with saline only.

3. We no longer change the caps after every blood draw they are changed weekly.

Overall we are moving away from using heparin when at all possible.

[oceangirl1234]

Our PICCS are valved. Weekly cap changes. 10 cc NS flush, waste 6-10 cc blood, draw your blood, flush with 20 cc NS. No heparin.

[mmc51264, BSN, MSN, RN]

we don't flush with heparin either. NS

[MunoRN, RN]

We do use heparin to lock certain types of lines, but we don't flush with it. For valved PICCs we flush with 20ml NS after a blood draw using a 'push-pause' technique, for midlines and peripherals we are using for blood draws we flush with 10ml. We don't change the caps/needless connectors after each blood draw, there's not really any benefit to that but you are manipulating a connection unnecessarily.

[NuGuyNurse2b]

We only flush with heparin if the line is clogged because some nurses, for whatever reason, leave the lines unclamped when not used. if that doesn't work then we tpa it. otherwise it's NS. for outpatients with picc lines, we flush with heparin before we discharge them.

[MikeyT-c-IV]

I would consider how often the lumen is being used to draw blood. It would be overkill to pack the lumen with heparin every couple of hours. Using a nice push-pause technique with saline flush would be sufficient to maintain patency in this scenario. If blood is drawn from a lumen only once a shift or day, then yes, it should be packed with heparin if that is your hospital policy.

In my hospital, I have heard of nurses drawing blood, flushing with saline, flush with heparin and then continue an infusion. The use of heparin in this scenario is not necessary. There is no reason to flush heparin through the line only to continue an infusion. We pack lumens with heparin in hopes that it will prevent a thrombotic occlusion while not in use.

I disagree with changing the cap after every blood draw. When doing so the closed system is open and the risk for infection increases. Infusion Nurses Society recommends replacing them no more frequently than 96 hour intervals. There are obviously other considerations for changing a needless access device but drawing blood is not one of them.

[AnnieOaklyRN, BSN, RN, EMT-P]

It depends on your hospital policy, but depending on how often the patient has labs drawn that could end up adding up!

At my hospital our policy is to flush with 20 mL of NS after lab draws.

We also never Heparinize our PICC lines, unless the patient is having frequent clotting issues and needing CathFlo.

Annie