Picc lines

look at your unit's policy book. prolly be faster than getting online to check an

Good question. I hate to be one of those posters but here is a link to basically the same question, with answers:

https://allnurses.com/infusion-nursing-intravenous/flushing-picc-line-322852.html

Thank you :)

One of the nursing interventions in obtaining a blood return could be attempts at flushing, however, my first intervention would be to attempt to aspirate first when I hook up a syringe, if I don't readily get a blood return then my nrsg interventions are employed: Turn head and cough, (the pt should try that, not you -lol) reposition the patient ie. if he is lying down flat, raise the HOB, reposition the arm, and if all else fails, try flushing a little in and then try drawing back. Please note that it IS IMPERATIVE that a catheter that terminates centrally yield a brisk blood return.

you probably have a clot forming if you can flush but not aspirate. In my facility this would be the time to a) replace the hub/cap as that is where many clots form and b) get an order for low-dose tPa. The infusion nurses society has excellent standards on all types of lines and their care/maintenance. Also, the vendor for your PICC kits probably has someone who can do in-services.

The lack of brisk blood return is one of the major indicators of a malpositioned catheter. If you are unable to obtain a brisk blood return you must attempt to reestablish blood return by utilizing an antithrombotic (alteplase) and/or obtaining a CXR1V to verify central placement. Fibrin sheaths or tails are not OK to leave in place. There is not just a patency issue but an infection control issue as well.

I was just consulted this past week to assess a PICC line in the ER when a patient presented with a line that did not draw blood. The line was placed in-house 5 days prior, placement was verified by ECG in the cavoatrial junction and later confirmed by a non-related CXR prior to discharge. I ordered a CXR1V in the ER and discovered that the line had migrated and now was placed within the internal jugular. Oops.

GrnTea, that is the best advice I have ever read. Simple and to the point and 100% accuracy! Love it