Policy development: Central lines

I don't have any evidence off hand, but our policy is every 7 days the site must be changed. However, if it's a groin line I believe the max is either 24 or 48 hrs.

No time limit here. They usually end up coming out if there's a fever of unknown origin and a culture comes back positive through the line and not a peripheral stick.

Dressing changes are at least every 7 days. Fem sites always seem to get filthy easily, they really should have a time limit.

No set time limit on line sites. If we suspect they are infected we do a new stick. Femoral lines we try to get out in 24 hours or less....just depends on how bad we really need that line.

Hi folks, need your input. I am an instructor in a nursing program and there seems to be some confusion concerning size of syringe when giving a med through a central/PICC line. 10 cc we know if you are using capped line...but what if you are administering through the Y site farther back from the cap (continuous IV infusing)..what size syringe..still a 10? I thought I read a couple of years back that you could use a 3 cc syringe of med only at the Y site....but of course, don't know where I read that.

Hi folks, need your input. I am an instructor in a nursing program and there seems to be some confusion concerning size of syringe when giving a med through a central/PICC line. 10 cc we know if you are using capped line...but what if you are administering through the Y site farther back from the cap (continuous IV infusing)..what size syringe..still a 10? I thought I read a couple of years back that you could use a 3 cc syringe of med only at the Y site....but of course, don't know where I read that.

It's medicine, it doesn't care what size syringe it's in, it's still gonna do the same job.

It's medicine, it doesn't care what size syringe it's in, it's still gonna do the same job.

I think its the pressure that a 3 cc syringe causes that causes concern, but I dont really know if it matteres anymore these days. Most piccs are power piccs and can handle it and you can push IV contrast under pressure ect,, and central lines are capeable of tolerating it I think, but the rationale we had in nursing school a few years ago was that 3 cc causes too much pressure. The wider 10 cc syringes are supposed to be better.

That is what is being practiced in this area. The 3cc syringes exert too much PSI on the tip of the catheter and can actually tear the tip off, causing it to end up in the circulation. Not a good thing. 10cc much lower PSI, which is why they are being used and why we continue to teach that practice.

We put our meds on a pump, some of our meds come in under 1ml so we don't have a choice but to use that syringe. But we always flush with a 10ml syringe because of the lower PSI.

That is what is being practiced in this area. The 3cc syringes exert too much PSI on the tip of the catheter and can actually tear the tip off, causing it to end up in the circulation. Not a good thing. 10cc much lower PSI, which is why they are being used and why we continue to teach that practice.

So how do you give 2 mg of Haldol, 10 mg Hydralazine, etc.? The doses are less than an mL. Draw it up in a heparin syringe and shoot it into a 10 mL syringe?

If your slamming something into someone (which you shouldn't be doing anywayssss) then I can see the high PSI, but if ur just giving a little squirt every 15-30 seconds then I have trouble believing that you'd tear the tip of a CVL off. But if someone has some literature on it I would love to see it.

So how do you give 2 mg of Haldol, 10 mg Hydralazine, etc.? The doses are less than an mL. Draw it up in a heparin syringe and shoot it into a 10 mL syringe?

Yeah, you pull it up into a 1 ml syringe, then empty THAT into a partialy emptied 10cc NS syringe. Inject solution over time as specified. Or, hook into a port in the main IV, pull up some of the maintainence fluids and inject slowly as specified. Either way, you have a dilute solution you can control.

I guess it may depend on the reason for the line, I kept a c-line 6 months in a patient in home care to receive chemo. It was removed because the chemo was over. No infections no problems.