Triple-Lumen Qestion

SusanKathleen, RN · Aug 31, 2008

Hi,

There was a good thread about this recently. Go to triple lumen PICC lines PICC chic Infusion Nursing or Intravenous Nursing 16 Feb 25, 2008 11:21 AM

*ac* · Aug 31, 2008

Please help me to understand this! I'm sheltered from most central-lines, as I work on a geriatric floor. We will soon have a patient with a central line, and will need to flush and heparinise the triple-lumen catheter. What is the proper technique for flushing these ports? When flushing a port while IV fluids are infusing, will I infuse into the port itself, or the nearest port on the IV line? I'd appreciate the advice.

I flush from the nearest port, not at the hub, so that I don't have to disconnect the tubing. "Breaking the line" supposedly increases infection rates. Also, if you draw blood from this line, make sure to clamp off the lumens you're not drawing from, otherwise you'll be getting whatever is infusing in them into your sample. The lumens are usuually color coded - and we mark the blood sample label with the lumen it was drawn from.

LearningTheRopes · Sep 1, 2008

Thanks for the tip! I've searched everywhere online, it seems, to find our more about PICC lines. All I could find was a bunch of studies talking about their 'risks for infection,' and I definitely don't want to do that to my patients!

It was hard for me to ask that question, but I want to really thank you for answering it. I've had my license for about nine months, and I feel like I should know all of these things. Not only that, but I'm afraid to ask, because I don't want to be seen as incompetent. Needless to say, it's been a nerve-racking and lonely rode staying up late, searching our information online. Thanks! It's good to know I'm not alone!

Pedi-Gree, BSN, RN · Sep 1, 2008

One big thing to remember is to be scrupulously careful about air. NO air in central lines, please! I'd also suggest using nothing smaller than a 10 mL syringe just to preserve the integrity of the lumen. You can use less than 10 mL of fluid, but the smaller the syringe, the higher the pressure it exerts on the line.

psalm, RN · Sep 1, 2008

Please help me to understand this! I'm sheltered from most central-lines, as I work on a geriatric floor. We will soon have a patient with a central line, and will need to flush and heparinise the triple-lumen catheter. What is the proper technique for flushing these ports? When flushing a port while IV fluids are infusing, will I infuse into the port itself, or the nearest port on the IV line? I'd appreciate the advice.

Be sure to check out your hospital's protocol, it should be written somewhere or on your intranet. Since you already know a pt. with a central line is coming, now's the time for all the nurses to be on the same page! If your hospital has an IV team, they would also be a good resource. Good Luck!

PICC ACE · Sep 2, 2008

You generally don't need to flush a line that is actively infusing unless some sort of occlusion is suspected or you need to interupt the infusion for some reason.

As for the unused lumens,the flushing procedure will have a slight variation depending on the style of catheter and the end caps. What sort of catheter is it,exactly,and what end cap does it have?

Another crucial aspect of catheter care to prepare for is proper securement and dressing change procedures. Make sure you get adequately inserviced on this as well.

IU Nurse · Sep 2, 2008

You generally don't need to flush a line that is actively infusing unless some sort of occlusion is suspected or you need to interupt the infusion for some reason.
As for the unused lumens,the flushing procedure will have a slight variation depending on the style of catheter and the end caps. What sort of catheter is it,exactly,and what end cap does it have?
Another crucial aspect of catheter care to prepare for is proper securement and dressing change procedures. Make sure you get adequately inserviced on this as well.

I am a new grad. I was taught the same thing. Only the lines not being used need to be flushed, as long as there are no signs of a problem e.g. redness, swollen, leaking, unable to push meds through line...).

The only incompetant nurse is the one who does not ask about something they do not understand. I would also encourage checking what your facility's policy is concerning flushing. I am still looking, but if you can find someone you trust to mentor you, that would ease your anxiety as well. :rolleyes:

NoviceToExpert · Sep 7, 2008

Another thing to remember is to never turn off a pump and leave the tubing connected to the port... your line will occlude... if you are not infusing... disconnect...also... make sure you are meticulous about cleaning the ports with an alcohol swab before connecting... and wait for it to dry for 30 seconds without letting it rest back on anything...make sure the dressing stays clean dry intact... when you change the dressing follow your hospital protocol... wear a mask... turn the patients head in the opposite direction so he/she doesn't breathe on it....

nerdtonurse?, BSN, RN · Sep 8, 2008

All I can add is that we change the ports every 7 days, and flush with either heparin or NS depending on what the doc ordered q8h; we have a procedure sheet that goes on the inside front of the chart, where it shows who last did what TLC maintenance (changed dressing, changed port, whatever).

dede1956 · Apr 29, 2010

Always check your hospital policy/procedure manual. When we flush our lines we are only flushing the open (nothing connected) lines, we don't flush the lines with fluids infusing. We use 10ml saline flush, our pharmacy stocks us with these prefilled syringes. Always clean the port with alchohol for 15 sec and dry for 15-30 sec prior to connecting IV tubing or any syringe with medication. Don't leave tubing connected once the infusion is done as it can occlude your line. There is nothing more frustrating than finding an occluded port when you need to give meds stat. good luck.