Syringe Size for Medications in CVL

[learnin2day]

What size syringe do you use when administering medications through a central venous line (Hickman, Groshong) with Ped pts? What do you do with smaller volumes of medication being sent by pharmacy in smaller syringes? Any input would be appreciated!! Thanks.

[NotReady4PrimeTime, RN]

We have a hospital policy that states the minimum size for use with all long-term central access lines (IVAD, PICC) is 10 mL. both for blood drawas and for flushing and medication administration. When pharmacy sends up meds in smaller syringes we put the med into a 10 mL syringe and dilute them with some NS or D5W before giving them. "Minimum" dilution isn't usually an issue unless the kid is tightly fluid restricted, generally NOT the case with kids who have long-term lines. We make heavy use of our syringe pumps for giving IV meds via any type of line; they aren't always necessary but it's easiest to put the syringe on a pump and run the med over 15 minutes or whatever minimum time recommended, then flush.

[learnin2day]

Thank you for your post!:) Forgive my ignorance, what is an IVAD?

[kristenncrn]

Our hospital has a similar policy except we use a 12 mL. If a med comes up in a 3 mL syringe, you just stick a needle on the 3 mL, pull back the plunger on the 12 mL and insert the syringe tip into the 12 mL barrel. With me? Then squirt the med into the larger syringe, throw it on a pump and get going. Oh and relabel it. Definitely relabel it (along with your date, time, initials - or whatever your hospital policy is.) I'm not a huge policy/procedure girl, but labeling syringes is essential.

IVAD - implated vascular device. Those things scare me. You may have heard of a port-a-cath? It's like a central line that has no external port - you access them with a special needle and the port is actually hidden subQ.

Best, Kristen

[learnin2day]

Thanks!