Quick question- PICC flushing

[Cat_RN, ASN, BSN, RN]

How many mL's of NS does it take to completely flush a PICC? 10mLs? I was flushing a power PICC yesterday between ABXs and wondered if I had completely cleared the line with the 10mL flush.

[Valhalla_Pure]

We use 10 cc flushes at our hospital. I haven't had a problem yet. If you meet resistance while flushing, something might be the problem, not the volume of your flush.

[Sl1011]

I use the push/pause technique and use 10mls.

[eriksoln, BSN, RN]

10cc flushes is the policy at my current facility and every other place I've been. I have to admit, I don't recall the reason behind it...............I believe it takes that much to completely flush the line.

[funkywoman]

10 ml with push pause technique, while on the subject never use smaller than a 10 cc syringe to flush a picc, can rupture the line, worked one hospital that routinely used 3 ml syringes and we actually had "picc repair kits"

[solneeshka, BSN, RN]

10 mL is the protocol at our facility, but the line doesn't actually hold that much. If you were to take a PICC line that wasn't inserted into a patient and hook a flush up to it, it would only take about 2-3 mL to flush the whole thing. I think the reason that 10 mL seems to be standard for flushing a PICC line that's actually in a patient is because something was always run through it before your flush (maybe not immediately before, but at some point) and when you flush a fluid through a fluid-filled line, you're going to have some amount of diffusion of the flush fluid into the existing line fluid. 10 mL is plenty to ensure that you've gotten everything that was sitting in the line out into the circulation.

[iluvivt, BSN, RN]

The general rule is to always have a minimum of 2x the priming volume of the CVC ..port or HD catheter that you are using..many nurses do not know those volumes so providers have policies in place for type and volumes of flushes for all types of CVCs. The PICC volumes are actually much smaller than stated above...they range from 0.5 ml - 1ml per lumen so you can see 10 ml is plenty. So for example, the power PICC dual lumen we use from BARD has a priming volume of .57 ml and its even less after we trim it prior to insertion. INS does recommend 10 ml of NS for all PICCS. we also have have them double the NS volume after blood draws and that helped decrease our thrombotic occlusios. As for the push pause method..no research to prove that it helps..many experts now state to use a nice and steady even flush but I have to say I am happy when they just do the flush in a timely manner.

[carolmaccas66, BSN, RN]

I've used 5 mls before giving medication and the 5 mls after to flush PICC lines, so 10 mls is adequate. And don't ever force the flush if you feel too much resistance, the catheter could be blocked, or could have strayed (this apparently happens sometimes).

[eriksoln, BSN, RN]

10 ml with push pause technique, while on the subject never use smaller than a 10 cc syringe to flush a picc, can rupture the line, worked one hospital that routinely used 3 ml syringes and we actually had "picc repair kits"

Ah, yes. This is what I heard (and had forgotten), something about the connection or pressure of a 3cc syringe being used isn't right.