I have a patient with a double lumen PICC who has PN stopped and might be restarted in a few days. She has many IV infusions throughout the day and medical team has asked for extra IV access since PN lumen needs to be left unused and the other lumen is not enough for all IV infusions.
My question is: once PN is stopped and lumen flushed, could it be used for any IVs infusion (fluids, antibiotics) and if PN is restarted, after being flushed, reconnect PN?
I undertsand higher risk of infection when PN is running and need to dedicated one lumen for it, but cannot find any evidence regarding not being able to use a PICC lumen for PN that has previously been used for something else.
Any guidleines/evidence regarding this?
Thanks
There is no evidence for this. While PN is NOT infusing, you can certainly use that lumen for other infusions. But when PN is restarted, nothing should be given through it. Infection prevention because PN grows fungi easily plus compatibility of meds and PN.
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thank you so much Lynn for your expertise. I also have a question about this dedicated PN lumen. Should it be better if the PN lumen is to be used for antibiotics? These meds could even in the inner cath lumen to prevent any germs growing.
Nice thought but it will not work. Doses given by the IV route is less than ABX doses used to lock a CVAD lumen. The supretherapeutic dose in the lock solution is needed to penetrate the biofilm, where the organisms live.
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Many thanks. I thought so but everyone is challenging my reasoning.