I had a question from a staff RN and was not sure of the answer. PICC line with mainline fluids running on a pump at 125ml/hr, needed to give iv medicine by push, used the extra port of mainline fluids tubing and used 3cc syringe. Staff RN then remembered that we use 10cc or larger syringe with PICC lines. Question is, with mainline fluids running do you have still have to use the 10cc or larger syringe? Is there still a pressure concern if pushing into IV tubing first?
Correct -as long as there is no occlusion alarms with the pump. However, you still need to assess several aspects before giving any medication. First is compatibility between the injected meds and any meds admixed in the infusing fluid. Second, a blood return from the catheter is required as part of the assessment of catheter patency before each med is given - both INS and ONS make this statement. A 10 ml syringe is not the total "safe harbor" that we have been led to believe. Any catheter that is open and patent and offering no resistance to flushing can have a 3 or 5 ml syringe attached to it with no problem. The risk of catheter damage comes when you use any size syringe and continue to apply force when you meet resistance. Force applied meeting resistance leads to increased intraluminal pressure that causes catheter rupture. Without resistance, any size syringe will work, although I would never recommend using a 1 mL. With resistance, even a 10 mL syringe can cause damage.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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