Question about drawing blood from PICC lines

[nurseinpa]

I was always taught that you flush with saline (hub to hub), draw out 10cc and waste, then draw the blood with a 10cc syringe, use a transfer device to put the blood in the blood tubes. I was recently told by one very snotty change nurse that the ONLY proper way was to to draw the blood directly from the PICC with a transfer device and put the blood tube directly into the device and draw directly from the line (without drawing into the 10cc syringe first, just using the vaccum from the tubes). I have never seen or heard of this before and neither has any of the nurses I asked. Some said that would put too much pressure on the PICC and that is why we use the 10cc syringes. Is this new or am I just out of touch? How do you do it? Thanks!

[lovingRN2009]

i draw blood off a picc the same way as you, using a syringe and transfer device because i was taught putting the transfer device directly on the picc puts too much pressure on it, although i have seen other nurses do it that way.

[iluvivt, BSN, RN]

Actually you are correct and NOT the charge nurse....the best and safest way to draw from a PICC is by using the syringe method you described.....the Infusion Nurses Society also recommends to use a syringe for a blood draw on all PICC lines for a variety of reasons...some PICCs ,such as the Groshong PICCs and SOLOs do not easily draw with a transfer device and the a vacuum tube attached to that..the valve will often be touchy and you will not be able to get a draw...it is also a good idea to pre-flush and verify patency before doing this...blood flow can be sluggish and while you are trying to draw you can clot off the PICC..yes I have seen this happen more than you would believe..much better to do the discard and draw with a syringe where you can actually feel what is happening

[nurseinpa]

Thank you for your response. She was so rude to me when I asked where the transfer devices were.

[picclineman]

There was an article about blood draws from the INS magazine about changing the caps first prior to blood drawing. Part of the reason wasm the old cap could be harboring bacteria. But yes i think drawing with the use of ten /twelve cc syringe is a better way. Better yet if you can clean the hubs with chlorascrub/alcohol, draw your specimen then apply a new cap after flushing willbe a good practice.

[iluvivt, BSN, RN]

so much controversy and unsolved issues about caps. research still on-going....actually better to change caps after a blood draw. you are correct .so the blood is not sitting in the dead space of the valve..also they said if using positive displacement valve/cap this is not necessary....I will ahve to locate where I found that but I do remember reading it

[nurseinpa]

I guess my question isn't whether or not to change the caps but whether to draw the bood from the line with a syringe or with the transfer device directly into the blood tubes. Thanks!