posted
I have heard mixed reports of contraindications for drawing blood from a PICCline. And yesterday my doctor said it increases the chance for infection.
Yesterday they tried to draw blood from y unPICCed arm and stuck me 3 times trying to get blood.
I don't want to shorten its usefullness. Anybody know about this? Thanks.
Posts: 830 | From Colorado | Registered: Mar 2005
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posted
My daughter went through eight picc lines and had to have her port a cath line replaced twice. The radiologist believes it is from drawing blood.
She now takes a baby aspirin every day, and flushes her port after blood draw with two saline and three heparin. Also uses two heparin after after antibiotic dose. No trouble now for over a year and a half.
By the way, her new llmd says she should not have blood drawn from her port!
She is going to IM bicillin, so hopefully, she will be able to have the port removed.
Posts: 132 | From Kentucky | Registered: Dec 2004
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My line is a groshong which I think means it doesn't take heparin, just saline to flush. Are the PICCs that require heparin different?
Posts: 830 | From Colorado | Registered: Mar 2005
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timaca
Frequent Contributor (1K+ posts)
Member # 6911
posted
Don't know the difference between a groshong and another kind of picc.
I have a picc in my left arm (bicep area). I've had it for 5 months. I've had blood taken out of it weekly. The extension was always changed afterwards, and it was flushed with 10cc normal saline and 2 cc heparin.
Posts: 2872 | From above 7,000 ft in a pine forest | Registered: Feb 2005
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posted
Cental lines, PICC's, Groshongs, and Port-a Caths, were all made for the purpose of giving intermittent medications and drawing blood. Yes, everytime you go in and out of it to give medications or draw blood, you are at risk for infection. That is why is is so important that you always use STERILE TECHNIQUE. That is what prevents infections. You should always use at least 10cc of sterile saline to flush. (port-a-caths require more saline and heparin too.) If you have a long extension on your line, don't be afraid to use a few extra cc's of saline. Always use a pulsating push when flushing and clamp your line immediately after the flush. Most lines that "clot off" do so because of improper flushing. I personally had my PICC in for 3 months with daily rocephin and weekly blood draws with no problems.
Posts: 114 | From Seaside, Calif. | Registered: Oct 2001
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WildCondor
Unregistered
posted
You should never get blood taken from a PICC line, Hickman, etc. It increases the chances of infection, and I got infections three times that way. Make sure you insist that your nurse NEVER take blood out of the line, even if they shrug it off and say that its okay, it is not true, and it is your body, and your life.
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posted
I am so glad I posted this. It has been very informative. I hope it helps others as much when they need to do a search on this subject.
Posts: 830 | From Colorado | Registered: Mar 2005
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posted
In response to Wildcondors post, if you got infections in your line, it was because whoever was accessing your line, whether giving medications or drawing blood, did not use proper sterile technique. I am an oncology nurse, post lyme disease, and I personally draw blood from different patients with different cental lines (piccs, groshongs, port-a-cath)about 6 times a day. And these are cancer patients that often have no white blood cells due to chemotherapy, who are at extreme high risk for infection. It is extremely rare for us to see an infection from a central line even in this patient population. I just hate to see people turned off from using these lines for what they were made for. Any infections in central lines are a fault of improper sterile technique, of someone not knowing what they are doing. Just be sure whoever is drawing your blood or giving you medications or teaching you how to, has had extensive training themselves in the use of central lines. Just remember, you have just as good a chance at causing an infection when giving an IV medication and flushing a central line as you do in drawing blood from it. It all comes down to PROPER STERILE TECHNIQUE.
Posts: 114 | From Seaside, Calif. | Registered: Oct 2001
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timaca
Frequent Contributor (1K+ posts)
Member # 6911
posted
Tootie~
How nice to read that you are an oncology nurse, and post lyme. I sure hope I can get to the place of feeling like I can work again and also say that I am "post lyme." Thanks for being encouraging in that way....
Posts: 2872 | From above 7,000 ft in a pine forest | Registered: Feb 2005
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posted
That's the whole point,thank you, Cave 76. You always have to be anal, fussy, and PICCy!!(love that, going to use it at work). These lines ARE great sources of infection if not used properly. That is why you didn't get an infection, you advocated for yourself! And by all means, don't be afraid to question your nurse!! Now I know you wern't referring to me as nurse Ratchet?? Were you??!! Tootie
Posts: 114 | From Seaside, Calif. | Registered: Oct 2001
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posted
OK, Cave and Tootie or others if interested,
I'm probably going to make you shudder with this question, but...here goes. When you say (anally )sterile technique, can you describe the technique? Do you ever not use rubber gloves? Do you scrub your hands before you infuse and use rubber gloves and use a new saline syringe to flush each time? Anything else? And of course cleaning the tip with alcohol before each infusion.
When I was in the hospital they infused without gloves. Is this safe?
And Tootie,
With all your experience, did you ever see anyone get blood clots around the PICC line after insertion? I think there was some trauma when she inserted it. I know she put it in and did an x-ray and she needed to put it in another 2 inches. Don't know if this is what caused the trauma. Just wondering.
Posts: 830 | From Colorado | Registered: Mar 2005
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What I meant by a brand new syringe each time, I didn't mean an old dirty one. I can see how that sounded like that! I meant I usually use (and was taught by home health) one syringe for each infusion, half before and half after, then discard the syringe.
I see with my new source of abx, they gave me double the syringes, so I can use 2 each time.
Thanks. It has been good being with you all.
Posts: 830 | From Colorado | Registered: Mar 2005
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timaca
Frequent Contributor (1K+ posts)
Member # 6911
posted
I use 10cc NS before each infusion, and 10cc NS after each infusion, followed by 2cc heparin.
I wash my hands before I touch the line, and use alcohol pads on the surfaces. I use a new tubing each time I infuse. I don't use gloves.
I did have to tell one nurse to not use her teeth to pull the cap off my extension tubing before hooking it up to me!!
So far...so good.
Posts: 2872 | From above 7,000 ft in a pine forest | Registered: Feb 2005
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posted
Hi all, I just had a picc line installed at the hospital yesterday. I asked the doctor who installed it about this and he said "though it is possible to draw blood through a picc line it is never recommended. It should be limited to infusing medications." and I quote. This guy installs 10 to 15 picc lines every day, all year. Just (my) his 2 cents. Kind regards, Kenny
Posts: 76 | From South Eastern PA | Registered: Sep 2005
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timaca
Frequent Contributor (1K+ posts)
Member # 6911
posted
I've had my picc line in since June 9th.
The nurse has never used her mouth since... Posts: 2872 | From above 7,000 ft in a pine forest | Registered: Feb 2005
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posted
My kids have PICC lines and have their weekly blood draws from the line. They have had their PICC lines for 6 months.
Their PICC lines have been used for sedation for a lumbar puncture. Jordan's has been used for 2 ACTH stimulation tests and for his angiogram/venogram.
My kids are on IV Primaxin. I wash my hands with Hibiclens. I use 3 alcohol wipes with each infusion. I flush the line with saline before the infusion and flush with saline and heparin after infusion.
I've been surprised by the line care at the clinic or hospital. I take care of the lines much better then they did.
-------------------- Peggy
~ ~ Hope is a powerful medicine. ~ ~ Posts: 2775 | From MN | Registered: Apr 2001
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quote:Originally posted by aliyalex: What did you use the 3 alcohol wipes for? Thanks.
1) clean the cap for 30 seconds before flushing with saline before infusing 2) wipe off the cap before flushing with saline after infusing 3) wipe off the cap before flushing with heparin after infusing
-------------------- Peggy
~ ~ Hope is a powerful medicine. ~ ~ Posts: 2775 | From MN | Registered: Apr 2001
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posted
OK. I'll start doing that tonight. Thanks.
Posts: 830 | From Colorado | Registered: Mar 2005
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WildCondor
Unregistered
posted
When you have a foreign object implanted under your skin leading into your heart, it can get infected in many ways. The saline solution, the heparin, the IV solution itself, all can get infected. You can breathe on it, it can get dirty, sweaty, etc when exposed to summer heat, showering, you name it.
Sterile technique was always used when I was receiving IV. You have to be very careful. What I am saving it, even if you follow all the rules, and you are are careful as possible, line infections still can happen. Drawing blood out is stupid and careless. It increases your chances of infection, and the blood taken from the line is usually mixed with saline, heparin, or whatever is in your line. of course it's easier for a nurse, because all you have to do is hook up the syringe to the line, you dont have to do a blood draw from a vein, so its quick and easy...and lazy too. I was really angry when I found out my nurse wasnt supposed to be drawing from the line. I got a new nurse soon after, one that knew what they were doing.
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posted
When I was in the hospital the other day for the blood clots, the male RN told me, "don't let anybody stick you when you have a PICC line. Each stick effects the integrity of the vein and the fewer, the better. That is what the PICC line is for."
I am really glad to hear all this information about infection potential, because I would have followed what the RN said. Now i won't. Thank you for that!
Posts: 830 | From Colorado | Registered: Mar 2005
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posted
For those of you who think that it is easier to draw blood from a PICC line for a nurse and that is why we (me being a nurse) do it, think again. The prep time just to get all the equipment together is about 5 minutes and about another 2 minutes to do the draw. (yes, the first tube drawn can have saline or heparin in it and that is why it should be always discarded). We can do a venipunture(needlestick draw) in about 1 minute. I have yet to meet a patient who would rather have a needle stuck in thier arm than have a painless draw from their PICC lline. In the hospital I work at, every single patient with central lines (about 75 patients a day), have their blood for lab work drawn from their PICC/central lines. Our radiologists and surgeons who insert the lines will tell you that they are for 2 things: infusing medications/blood transfusions and drawing blood for lab work. I just hate to see anyone (especially children with Lyme Disease or cancer) go through a painful needle stick when they have a PICC, when, in my opinion and all the doctors I know, it is totally unnecessary! Again, proper sterile technique will prevent any chance of infection!!!
Posts: 114 | From Seaside, Calif. | Registered: Oct 2001
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arg82
Frequent Contributor (1K+ posts)
Member # 161
posted
Well put, Tootie. It's nice to have a nurse here who deals with these issues on a daily basis.
I had a PICC for six months in 2002, had no problems with it, but didn't have blood draws through it because I didn't know it was possible. I had to go out to the lab every other week and get stuck in my one good vein (which now has quite a bit of scar tissue on it so who knows how much longer it will be good for). Now I have a port-a-cath (for almost a year and a half) and I've always done my blood draws through it - 3 1/2 months of draws every other week in 2004 and now going on 4 months of weekly blood draws. I've had no problems, I'm able to draw my own labs (I take care of my port myself, no nursing care unless there is a problem), and it has saved my veins a lot of wear and tear. I always draw a tube first to be discarded to make sure that it's just blood that's being tested. My veins are awful and one of the draws of having a central line is the ability to do blood draws through it. Granted, I have a different kind of line than what you're all talking about, but it's still a central line.
I think it comes down to the individual person and what his/her doctor and nursing company prefer but if it saves needlesticks and veins, I think it whould definitely at least be discussed with them.
I know people who have had infections but never had blood drawn through their lines. And I've always drawn through my port and have had no problems at all with it in almost a year and a half. So I think there are a lot of other factors that contribute to getting an infection. (I am also not quite as anal about everything when I infuse and everything - no gloves and I use the same tubing multiple times as taught by my nurse. I infuse three times a day so it would be a lot of tubing to use up to use a new one each time. I also use 5cc of saline before and after followed by 5cc of heparin.)
posted
I left something out...when they do stick you, and you have a PICC line, make sure its the other arm they stick, or a vein in the hand, etc, not the same vein that the line is in. Tootie is experienced, and knows what she is doing. Unfortunately, many nurses that typical Lyme patients come across have no clue what they are doing, don't know how to draw through a line, are bad phlebotomist etc. It all depends on the situation. Based on my experience and several other people I know who have gotten line infections, its simply not worth the risk to draw blood through the line. The only time getting blood drawn from my line was helpful instead of harmful was when they drew blood out of it to do a blood culture..one that grew the gram negative bacteria that almost killed me, 24 hours later. Blood from the Hickman line showed the bacteria, blood from a regular vein, showed nothing....until 24 hours later. Just be careful with who you trust with your PICC, Hickman or port. Dont let just anyone use it. Make sure you know them and have trusted them before. If anything seems "off" like they are don't know what they are doing or have to call somebody in for help...dont let them do it!
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