PICC lines

jillyk*rn · Apr 4, 2006

we use lots of picc's on our peds unit and rarely do we have a problem with them. they seem to do better than a standard cvc.

Irishgirl · Apr 4, 2006

What happens if the cap is left off too long & air gets in? How long is too long for the cap to be removed after drawing blood? Do you have time to put the blood down and pick up the new cap?? I'm worried about screwing up w/ a PICC line...never used them.

jillyk*rn · Apr 4, 2006

Hi,

Clamp it to change the cap. We have a needleless system, we don't take the cap off to draw blood. If a Blood Culture is needed, change the cap first and keep it sterile.

That's what we do.

Irishgirl · Apr 4, 2006

This PICC didn't have a clamp; I don't know if it's a different type than yours. No clamp at all :uhoh21:

pugmum · Apr 4, 2006

This PICC didn't have a clamp; I don't know if it's a different type than yours. No clamp at all :uhoh21:

Our PICCS are valved, and don't need a clamp...perhaps this is why you don't have clamps on your.

Altra, BSN, RN · Apr 4, 2006

There are probably many different systems - I'm having a hard time picturing what you mean by taking (and leaving) the cap off ...

The PICCs I've worked with have the same kind of tip as a regular peripheral IV - either needleless or not. To draw blood from this isn't a sterile procedure. My facility's P&P dictates cleaning w/3 alcohol swabs, drawing off a 5cc waste, then drawing whatever blood you need. If a syringe is used, it must be at least a 10cc.

As far as the vacutainer lying on the bedside table ... what comes directly into contact w/the PICC is the blood collection needle or syringe tip. Unless you've stood the syringe tip-down on the table, which you wouldn't of course, or left the uncapped collection needle lying around, which you wouldn't do either ... I don't see any problem.

letina · Apr 4, 2006

This PICC didn't have a clamp; I don't know if it's a different type than yours. No clamp at all :uhoh21:

The PICC lines we use don't have clamps, so don't know if they are the same as yours. Ours have pressure-sensitive 2 way valves at the internal end of the PICC. This valve opens outwards to allow fluid to be injected into the catheter and inwards to allow blood to be drawn. When not in use, the valve remains closed, preventing blood from flowing back into the catheter and air entering the venous circulation, thus reducing the risk of infection.

Blee O'Myacin, BSN, RN · Apr 4, 2006

I have a question w/ PICC lines. How easy is it for a patient to get an infection from these? I'm new with them. I saw a nurse draw blood from it, after having the vacutainer sitting on the bedside tabe, but it wasn't touching anything. Can air cause an infection? I just wonder with central lines. Is it easier to get an infection from these than regular peripheral IV's.

As long as the cap was swabbed with alcohol, then it was OK. I use a 10cc syringe to draw blood since you need to waste some due to saline sitting in the line (or heparin if that is what your facility uses) - our policy says that we need to change the cap following transfusions and blood draws, so I just keep some in my pocket (wrapped of course).

Personally, I wouldn't use a vacutainer with a PICC because I was taught to use the syringe and am more comfortable that way, but I've seen it done the other way and there is nothing wrong with it.

Blee

EmilyCCRN · Apr 4, 2006

Can air cause an infection?

An air embolus is extremely dangerous and can easily be fatal!!!!

purplemania, BSN, RN · Apr 4, 2006

For starts, a PICC line IS a central line, only inserted peripherally. When inserted, sterile technique is used. I would think that strict asceptic technique would be the minimum - at least if I have one! You are right to be cautious.

Irishgirl · Apr 4, 2006

I'm sorry, I'm having trouble reading my replies b/c my computer won't let me view all of my replies normally.