If you have to push that hard to flush.something is wrong and the line needs to be evaluated. I do not also agree with the nurse that said to push harder to flush. I would prefer to feel how much resistance there is in the line. Please see IVT forum as i just wrote out the step by step guide for this. Personally I do not like or use the stopcock method to administer Tpa though it is still considered an acceptable practice. It is OK to attempt to withdraw from it and get some blood. Just remember that if use a PICC from another ease verify where the tip is before you use it for infusion therapies. it is a matter of frequent access and manipulation of the system and not the temporary interruption of the TPN that is the concern here. Some facilities will not allow this b/c of increased infection risk that these patients have. One reason not to use a PICC is if it is a dedicated line being used for TPN. Provide good cap care.scrub injection cap or PD cap with a vigorous 15 sec scrub of alcohol or GHG (whatever your facility uses)ĥ. Always have all your necessary equipment ready and at hand and flush immediately after the draw with a pulsatile push pause method.Ĥ. I find the pre flush very helpful with the valved PICCS ( Groshong,PASV and SOLO).ģ. YES you can pre-flush b/f a blood draw b/c you are going to turn around and discard it anyway. You just need to perform the task properly.Ģ. YES YES YES you can draw blood from a PICC line. If the CVC (a PICC is a type of CVC) has a PWO it needs to be treated with Tpa. APWO is where you can instill but not easily withdraw blood. Any CVC can become occluded or have what is called a PWO (persistent withdrawal occlusion).
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