PICC Line with TPN going, How to give Benadryl IV?

[eleuter]

How to give Benadryl IV if pt have going TPN in a PICC?

[TheCommuter, BSN, RN]

I've always stopped the TPN and started the medication. Once the medication has completely infused, I'll restart the TPN.

[ParkerBC,MSN,RN, PhD, RN]

Ditto.

[retiredlady]

I was taught never to infuse anything in a TPN line. We always had a separate line for anything else.

[Sun0408, ASN, RN]

Does this PICC only have one lumen?? I have paused the TPN,flushed, gave med,flushed again, then restarted the TPN. If the pt is getting a lot of IVP meds or piggy backs, I would start a new line.

[iluvivt, BSN, RN]

TPN should always be a dedicated lumen. So if you only have a SL (single lumen) you should not be administering anything else in that lumen. If you have a dual lumen or a triple lumen PICC then you can use one of the other lumen(s) and leave the TPN or TPN and lipids (whatever the case) infusing.

If this is a SL the best course of action is to start a PIV. Then if you need a multi-lumen PICC you can address that as well.

[RNmomof3boys]

If there is only a single lumen picc I pause the ton do 2-3 flushes, the med(s) and then 2-3 more flushes. If there are lipids running I do not put anything in the line without checking with our pharmacists. Hope this helps!!!:)

[hodgieRN]

If it's only one lumen, like a port, and you need to give multiple meds throughout the day, there's nothing wrong with starting a PIV.

[turnforthenurse, MSN, NP]

Start a peripheral line. I personally don't see the point of having a single lumen "power PICC"...AT LEAST make it a double lumen.

[SaoirseRN]

We generally have the PICC (if single lumen) dedicated to the TPN and a peripheral line for medications. Ideally a multi-lumen PICC is the best-case scenario. In absence of same, a peripheral site is the best choice.

[anotherone, BSN, RN]

in my facility tpn is a dedicated lumen no exceptions. peripheral needs to he started or another central access

[PedRN86]

I would see about starting a peripheral line for medications or if that is not an option, consult pharmacy.

Usually I've found it's okay to do a flush, run the med, flush, then restart the line. But if they have a lot of meds (ie. Antibiotics, etc) we collaborate with the RD to alter the TPN/lipid rate to compensate for the lost TPN infusion time (increase the TPN rate as it will only run maybe 20 hours total).