Returning blood waste back into a PICC

[chenoaspirit]

Another thread has me wondering....why cant we return the waste blood back into a PICC. If you cleanse the port with alcohol swab prior to accessing (just as if you were administering a drug) why cant you return the blood? I mean, it would be the same as infusing a med via IV push, except it would be their blood rather than a drug. So how would contamination be an issue? The syrings is sterile, and you flush afterward. Im just wondering because when we draw coags from a PICC, we have to waste 20 ml's...thats ALOT to waste everyday or q 12 hours, especially if they already have a low H&H. Your opinions? ICU here returns it, but they have a special line that they draw it with (Im not sure what its called)

[RazorbackRN, BSN, RN]

Would I be correct to assume that you are speaking of the adult population? I work in a ped. CVICU and we need every little bit of blood in these babies we can get, so of course everything is returned.

[MoopleRN]

To the OP: you have to waste 20 mL? Seriously? That's 4 times what we're required to waste. And no, I would NEVER return a waste. If it's a difficult draw, or even if it doesn't appear to be, the RBCs may get lysed/damaged in the process. My facility's P&P doesn't allow us to return any blood. I'm still trying to wrap my head around the fact that you're required to waste 20 mL.... 20 mL NS is what we flush with afterwards on a PAC, we certainly don't waste 20 mL of blood for every line draw..... I must have misunderstand something somewhere....

[BlessedOne]

To Delana RN -- I am a vascular nurse and if that is your policy and the policy of most or all the dialysis centers, I see why patients are coming back to the floor with infected or clotted AVG, AVF and TDCs. We had so many in the past month. We have had many patient's grafts taken out and replaced. Give them additional procrit rather than returning blood that could have become infected or clotted off . What are your thoughts?

But to the original poster- I agree with all the other posters. You will be introducing the patient to infections and clots.

[debthern]

We never retrun our wastes either. We are getting some new tubing, that sets up on a CVP or A line, that will be self contained, and your waste will be captured in a little chamber, and when you are done with the sample you can give back the waste. Never exposed to air. I have not used it, they just had them at our meeting on Monday, but then this will not be on every patient.

we use this tubing very user friendly and self contained...

[marilynmom, LPN, NP]

I work in the PICU as well and we always return our waste.

It's different for kids though, any adults I have ever worked with we never return waste.

[aeauooo]

Remember that 20ml is 4 teaspoons, which may be a lot for a pediatric patient, but generally not for an adult.