quick PICC questions

[onthejourney]

1) Should you always choose to infuse into the large PICC lumen vs the small? and what is the purpose of having a small and large lumen, why not just have two lumens the same size?

2) Also, can you access and flush one of the lumens while an infusion is running into the other? For example you have to run an antibiotic so you access, flush and hook up the antibiotic to the lumen you know works then while the medication is infusing in the one port you access and flush the other lumen ( I was taught what you do to one side you do to the other).

3) Also is it ok to simply reinforce a PICC dressing if the dressing is peeling (and its been less than a week) or should you just apply a new dressing due to possible contamination?

thanks,

onthejourney

[tokmom, BSN, RN]

i have never heard of a picc having two different size lumens. not at my facility anyway.

2) also, can you access and flush one of the lumens while an infusion is running into the other? for example you have to run an antibiotic so you access, flush and hook up the antibiotic to the lumen you know works then while the medication is infusing in the one port you access and flush the other lumen ( i was taught what you do to one side you do to the other).

yes, you can flush one and leave the other infusing. that is why you have multiple lumens.

now if both are locked, then i would flush both at the same time. it makes no sense to me if the other lumen is infusing an abx that you would stop...unhook...flush and rehook and start up the abx again. is that what you mean?

3) also is it ok to simply reinforce a picc dressing if the dressing is peeling (and its been less than a week) or should you just apply a new dressing due to possible contamination?

no, change the entire thing, imo

what does your hospital policy say about the above questions?

[PMFB-RN, RN]

1) should you always choose to infuse into the large picc lumen vs the small?

*** no, infuse through the most appropiate lumen. for example if your patient is recieving a dopamine drip and you are or may have to also administer large amounts of fluids run the dopamine through the smaller lumen leaving the large one available for faster administration of fluids.

and what is the purpose of having a small and large lumen, why not just have two lumens the same size?

*** some piccs are that way. the advantage of having two different sizes is that you can have one larger lumen without increasing the outside diameter of the picc. the larger the picc the greater chance for thrombosis and other complications. the vast majority of things adminstered through piccs can and should be given throught the smaller lumen leaving the larger for cvp monitoring, blood draws, or fluid bolus administration.

2) also, can you access and flush one of the lumens while an infusion is running into the other?

*** yes you can. that is the point of having more than one lumen.

3) also is it ok to simply reinforce a picc dressing if the dressing is peeling (and its been less than a week) or should you just apply a new dressing due to possible contamination?

*** you should follow your hospital's policy. however if your hospital's policy doesn't call for changing of the dressing, the policy is wrong.