cannulation

Thanks that is how use the smartsite so I am right thanks for confirming this.

This might be a silly question. Smartsite needle free access valve (not smartsite plus). I know how to use it i.e. clamp prior to removing syringe. But does a smartsite provide a positive pressure or neutral, do I need to provide positive pressure on my syringe when I get to the last 0.5ml when dealing with central venous access devices to prevent blood being drawn back in or does just clamping prior to removal have the same effect. Thanks

This has been very helpful Many Thanks

Many thanks

Could anyone answer this for me - short term multi lumen cvc, if there is an infusion on one or two lumen and the third is free for blood draw is it vital that the other infusions are stopped prior to blood draw? Many Thanks:typing

I need advice our hospital policy states that before nurses can access a Hickman line for the first time blood draw must be made to ensure placement and also no problems such as a fibrin sheath. If it is a continous infusion going through blood draw would only be required once, however if it is not a continous infusion blood draw is needed each time to ensure no complications. The other day I was called to a ward to advise nurses had a new hickman line could not get blood. Treated as a fibrin sheath as could flush. Still not able to draw blood outcome consultant gave me a lecture on the fact we would never get blood from a hickman line as the line closes in on itself. The doctors therefore had to start first infusion of TPN. No complications so nurses able to change TPN and flush. Can anyone advise on why no blood draw.

Dear Cored42 regarding subcutaneous infusions, our hospital (in England) uses a product made by Becton Dickinson (BD) called a Saf-T Intama it is normally used for IV access. We use the blue one size 22 gauge as this provides the right length. You need to prime it with normal saline prior to insertion. If you wish I can e-mail you our policy and also provide a reference for an article on its use written by my colleague. As there is no needle under the skin the device can stay in up to 7 days depending on what is being administered. We use a line that has a 0.6 priming volume to assist with timing of drugs given via a syringe driver. Hope this helps

Can blood be withdrawn from piccs

Sorry to trouble people again, another question re midlines. Are there any special considerations when giving a blood transfusion via a midline?

Thanks for the information most helpful:nuke:

Thanks sbivrn sorry misread your last message, all clear now

Thanks sbivrn, very useful information do you know of any articles that define what you have told me about blood draw from midlines.

At our hospital we have ported cannulas peripheral, on which we use no less than a 10ml syringe, unless we have a smart site on (needle free access device, that has a short line that conects to the end of the cannula) which means we are not using the port and so can use a 5ml syringe. For all our midlines and central lines minimum size is 10 ml due the the pressure created by smaller syringes. I work in a hospital in the UK.

The use of midlines within our hospital is improving but needs to be improved on, yes sbivrn the same method is used. I have not had experience of putting in midlines myself yet, I need to be trained, but I am writing a policy on midlines, so checking best practice. I have one more question sbivrn, do you routinely withdraw blood from your midlines to confirm placement as done with central lines, I would say not due to small lumen creates more complications, I would use other observations to ensure tip placement, but I would value your experience.

Thanks for that Nurse Drumm, I have read a couple of articles that recomend the guaze.