triple lumen PICC flush

[ludoo00]

Hi there!!

I was just curious to find out if all lumens shoud be flushed after administration of a drug with SASH method or just the port in use? Any IV specialist? Thanks for your reply.

[mrscurtwkids4]

After medication dosing, I normally only flush the line that was used. But all the lumens should be flushed periodically regardless of whether it was used in order to maintain its patency. When in doubt, would think it better to flush it anyway. Won't really hurt anyone to get a little extra fluid from flushing.

[ludoo00]

thanks for the answer. Should the 3 be flushed with heparin too (I'm justwondering if it wouldn't be too much heparin)?

[iluvivt, BSN, RN]

you do not need to nor should you flush all the lumens after just using one lumen. The heparin can add up. In addition if I remember correctly there is a 30 ml limit use on NS if it has a preservative in it. Also why needlessly access the system increasing risk of infection. of course, this does not include routine daily flushing per your organizations policies. The one exception is after using a power injetable lumen after a power injection.All locked lumens should be flushed. We just found out about this recommendation.

[clayah]

Wow! I wasn't aware that there is a restriction of 30 ml Normal Saline flushes due to the preservative.

Can anyone tell me where I can obtain more information on this?

Thanks.:nuke:

[iluvivt, BSN, RN]

The preservative seen in normal saline used for flushing is called benzyl alcohol. It is contrindicated for neonates due to the potential for severe respiratory complications (fatal gasping syndrome) and metabolic complications. Its use in the adult population becomes a concern with the use of NS flushes B/C it can add up. (also used in some medications but amts are neglidgeable) In my ares we switched to NS prefills since we wanted to get away from the vials and the temptation from multiple access into the vial. It is still around though and can be used as an alternate for SQ lidocaine prior to venipuncture. I will try to find out more if anyone interested:yeah:

[clayah]

Illuvit,

Thank you so much for this information - we use prefilled NS syringes but have the NS vials in stock also. I appreciate any info you may have on this subject, but I will also try to google so I can submit the evidence based info to my unit.