PICC's

From my experience... you can use either.... as long as a med isn't infusing through them... and you always want to waste 2-3 cc of blood prior to drawing the sample. If I had to choose I would choose the brown lol but its a random guess...but technically you could draw blood from either... oh and if you are drawing med levels you want to use the port that was not used to infuse the med unless you have to and then you flush it really well :)

I have the same experience. You can use either as far as you continue to use the same one for blood drawn and the other one for IV infuse.

The only thing I found in the literature is that blood should be drawn from a catheter >4-6Fr. It also specified that blood draws shorten the life of a PICC. If both your lumens are the same diameter, use either.

Thank you for the responses.

Yes!! Never draw blood from anything less then a 4... we have a lot of 2s (babys) and the pressure can break it apart and then it can get caught in the heart or any other part of the patient (fyi that is not good)

depends on the picc.

with some piccs, each lumen is exactly the same. same gauge, lumens exit at the same place. (this type seems to be more common to me, but it just could be the part of the country i am in)

with other piccs, the lumen size varies, and/or the lumens may "exit" the picc at different points (like a triple lumen), giving you a proximal and distal port. arrow makes this type of picc catheter.

in the first case, the blood can be drawn from either port, as they are equal.

in the second case, the blood should be drawn from the largest port, and/or the most distal port. however, it can be drawn from either port, just like a triple lumen (blood should be drawn from the 16g distal port, but really can be drawn from any port, unless facility policy states otherwise), if both ports are large enough.

tradition dictates that blood is drawn from the brown port, but that is more tradition than an absolute. as a previous poster stated, you shouldn't draw a drug level out of the same lumen a drug is infused from (don't draw a vanc trough from a line you infuse vanc through). color-coding the ports is helpful for this; you draw the drug levels from the brown port and infuse the drugs through the white port. however, this only works if everyone is on the same page.

Unfortunately I'm a tad of a PICC expert considering line #12 is currently taking residence in my upper right arm. As for drawing blood from different ports, it is a bit of trick question, especially because every brand of line has different colored ports/lumens. IF there is a red one (which I usually have one as mine are Power PICCs), we tend to use that one just because it's easy to remember, but as long as the gauge is big enough it shouldn't matter. If I've learned anything about drawing labs from PICCs it's that there are a zillion and one different ways to do it. The way that has been decided to use on mine is flush 10ccs saline, waste 10cc, draw labs, flush 10cc saline, hep lock. There are varying amounts of flush, if you should flush first, etc, etc. Just make sure you stop anything that's going in the other lumen, especially if it's TPN! If you have any other questions let me know!

Where I work it does not matter. We have to stop any fluids/TPN for 15 minutes before you draw the blood. Flush with 10cc NS, waste 10cc blood, draw the sample, the flush with 20cc NS and heparin if indicated for that type of PICC. I have never been told that only certain ports can be used.

As a hem/onc nurse I deal with piccs on a daily basis. Most of the ones here are arrows, power or groshong piccs. You can draw from either port using the same technique as several people have stated above.

was always instructed to use brown for blood, sometimes the brown is red again for blood....i have had to draw from the white when was unable to get bloood from brown/red , i was also instructed to always draw off for discard around 6-7 cc, and remember to flush with 20 cc of NS after any blood draw

Thank you. My question has been answered re to PICC blood draw. I haven't done it in awhile , but it really hasn't changed.

We have a policy at my work that states we are NEVER to draw from a PICC. I was puzzled to learn this d/t the fact I have always drawn from them in other facilities as long as the lumen was big enough. I agree with the techniques listed above.

The story a heard is that a nurse ruined a smaller lumen PICC line and the doc was so furious that he/she went to the policy comity and convinced them that as a blanket rule there will be no blood draws from PICC's.

I've had some very po'd pt's d/t this policy they have had blood drawn for weeks using the PICC then I tell them I'm sorry it's against our policy you will have to have a needle...grrr.