Push Cephalosporins through a PICC line?

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More specifically, the drug was Maxipime. Looked it up in our drug manual that we have here on the floor, said it was OK to push 3-5 mins. I diluted it correctly, flushed the PICC with NS with no problems, but when I went to give the MAxipime, I felt a lot of resistance. I immediately withdrew, flushed again with NS (there was, then just ran it on the IV pump. What happened? did it crystalized? Is there some type of contraindication regarding pushing cephalosporins through a PICC line? I do it all the time through a PIV with no problems.

Please note that this is on a pediatric unit using a 4 french catheter PICC line.

Thanks

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Specializes in cardiac/critical care/ informatics.

what size syringe did you use? the bigger the syringe the more resistance there is. 60cc are difficult to push. just a thought.

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Specializes in Med/Surge, ER.
what size syringe did you use? the bigger the syringe the more resistance there is. 60cc are difficult to push. just a thought.

I agree.

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Specializes in ER, ICU, Infusion, peds, informatics.

is the medicine thick? what gauge is the picc?

i've never pushed cefipime, but i know that some of the cephalosporins (rocephin) can be pretty thick when you mix them up.

a 4f picc is pretty small (to me; i know it isn't that small for a peds pt), and it may be pretty tough to push something thick through it the whole length of the picc. it really depends on what gauge the picc is. french size tells you the outer dimensions of the picc. gauge tells you how big the lumen of the picc is. a 4f could be an 18 g if it is a single lumen, depending on the materials/who manufactured it. if it is a dl, then it is probably closer to a 20/22 g.

even if it is large, though, you have to remember that when you give something ivp though a short iv, you only have to overcome resistance for an inch or so (the length of the iv). when you give something though a picc, you have to overcome resistance for the entire length of the picc -- probably 20-30 cm in peds patients, i'm not sure. i know most piccs i place (adults only :) ) range from 30- 60 cm long depending on pt size, where on the arm the picc is placed, wheather it is placed in the right arm vs the left arm.

long answer to your question. short version: no, there is no absolute contraindication against pushing a cephalosporin through a picc.

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what size syringe did you use? the bigger the syringe the more resistance there is. 60cc are difficult to push. just a thought.

a 10 cc syringe

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is the medicine thick? what gauge is the picc?

i've never pushed cefipime, but i know that some of the cephalosporins (rocephin) can be pretty thick when you mix them up.

a 4f picc is pretty small (to me; i know it isn't that small for a peds pt), and it may be pretty tough to push something thick through it the whole length of the picc. it really depends on what gauge the picc is. french size tells you the outer dimensions of the picc. gauge tells you how big the lumen of the picc is. a 4f could be an 18 g if it is a single lumen, depending on the materials/who manufactured it. if it is a dl, then it is probably closer to a 20/22 g.

even if it is large, though, you have to remember that when you give something ivp though a short iv, you only have to overcome resistance for an inch or so (the length of the iv). when you give something though a picc, you have to overcome resistance for the entire length of the picc -- probably 20-30 cm in peds patients, i'm not sure. i know most piccs i place (adults only :) ) range from 30- 60 cm long depending on pt size, where on the arm the picc is placed, wheather it is placed in the right arm vs the left arm.

long answer to your question. short version: no, there is no absolute contraindication against pushing a cephalosporin through a picc.

ahhh i see...

well i'm not sure what guage it is, just that it is a 4 french and the length is 40 to 16 cm.

anyways, i went to push it again tonite and it worked just fine so who knows! maybe it was just positional.

oh and as far as pushing the maxipime, at our facility we are clear to push all cephalosporins which includes maxipime. thanks for all the help!

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