RN

[dragmarc]

Our policy for PICC lines states that there should be a flashback prior to recieving a medication. The physician is saying that it isn't necessary and that we should give the medicine if the PICC line flushes with NS. Who is correct?

[SoldierNurse22, BSN, RN]

If you're not getting blood from a PICC line but it still flushes, you could have a fibrin sheath over the end that's preventing blood return but still allowing it to flush...

OR

You could also have a PICC line that's wandered out of place and is no longer functional.

Bottom line, if you're not getting blood back from a PICC, it's a good idea to check placement and perhaps use some TPA. That was our policy on my oncology ward.

The Infusing Nursing Standards of Practice would agree:

http://www.ins1.org/files/public/QA_Session_1_Webinar.pdf

Standard 50 Flushing, Practice Criteria N. "The nurse should aspirate the

catheter for positive blood return to confirm patency prior to administration

of medications and solutions."

- Standard 68 Parenteral Medication and Solution Administration, Practice

Criteria A. The same statement is repeated

[Asystole RN]

He is wrong.

Any central line should be able to draw blood at any time. If it does not it either needs confirmation of functioning status such as a dye study or it needs to be fixed.

[HMarie13]

I agree with the other 2 comments. It should always have blood return.