Policy/Practice with capped PICC

Published

Your baby's PICC is capped and clamped.

1) What is routine care (flushes) if you are not giving anything through it?

2) How do you flush with frequent intermittent meds? NS? Hep NS?

We have scheduled hep NS flushes TID. Then when there are intermittent meds between and with those, people flush differently.

Specializes in Neonatal ICU (Cardiothoracic).

We don't cap PICCs here. We run KVO 1.2cc/hr fluids. Otherwise we get a PIV for meds, and get that line the heck out of the kid.

Up Vote Up Vote ×

This is VERY interesting! We have kids keeping their PICC capped/clamped until they are going home ALL THE TIME. It's kind of the norm. Our kids, especially gut kids, slowly go up on their continuous feeds and down on their TPN until it is turned off and they are at their full feeds continously. Then we cap it off - for a long time, like I said! We will continuously ask in rounds to D/C it for risk of infection... but because our kids are so difficult to get them in sometimes, they say they're not taking it out until they "trust them." So even with no intermittent meds, there is nothing running and we just flush it and keep it. Also, saline wells have a bed rep on our unit - they always go bad too quickly and we're sticking kids all the time it seems.

Up Vote Up Vote ×
Specializes in Neonatal ICU (Cardiothoracic).

Wow. The second a kid reaches a high enough PO intake, out that line comes.

Up Vote Up Vote ×
Specializes in NICU Level III.

I don't think I've ever seen a PICC on my unit that was capped.

Up Vote Up Vote ×
Specializes in NICU, PICU, educator.

We hep lock ours.....usually the kids that have them are terrible sticks, so we leave them, esp if they have intermittent IV meds...why stick them over and over if you don't have to? We rarely have one clot off. We also use the positve/neg pressure caps (I can NEVER remember which on it is LOL) on the end to help with preventing backup and clotting.

Up Vote Up Vote ×

We put the kids on 1ml clears and then the next day HL/SL and check a glucose an hr later, then pull them. Sometimes we leave them in till the next day. But usually no longer than that. It would be nice to have the pressure caps, esp on the little ones who advance to full feeds with no problem, you pull the PICC and then they get sick.

Up Vote Up Vote ×
Specializes in NICU.

The only time we leave ours in with just a small amount of fluid running is when we are keeping the line open for antibiotics. As soon as they reach full feeds, we keep the line open with clear fluids for an extra day (or so), then it gets pulled. And there are times where it seems like kids always get sick (usually NEC or something awful like that) a few days after their nice central line gets pulled. But I guess that's just the luck of the draw...

Up Vote Up Vote ×
+ Join the Discussion