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aspirating PICC lines when using a CADD pump

We have 2 Home IV programs currently in my hospital system.  Both programs utilize PICC lines and CADD pumps.  In one program we aspirate for blood with PICC lines during our every 4 day tubing change.  In the other program we do not.  The rationale for not aspirating the PICC line is that the CADD pump is a closed system and there is no difference from before the tubing to change to after, so no aspiration is required.  I am trying to figure out what is right so we can standardize our procedure.  There is resistance to aspirate PICC lines when using the CADD as this increases the work load of the Home IV program when the Home Care nurse can not get back blood as the patient is sent to the nurse at the Home IV program for Cathflo.  Any ideas on this one?  Thanks

 Kerry Stewart

National standards and

National standards and guidelines from both INS and ONS emphasize the importance of assessing for a blood return from all catheters prior to using that catheter for any medication. In home care, there is concern about teaching patients to aspirate for a blood return. So the most common practice is to perform a complete catheter assessment with each nursing visit which does include aspiration for a brisk, free-flowing blood return. The purpose has nothing to do with the function of the pump. It has everything to do with the function of the catheter. Lack of a blood return is a major sign that the catheter is not adequately functioning as it should and this is also documented to cause severe complications such as extravasation injury. Please locate the following for more information about the cause:

Hadaway, L., 2005, Reopen the pipeline for I.V. therapy: Nursing2005, v. 35, p. 54-63.

So checking for the blood return is the correct action to take. 


Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Patti Atteberry
Patti Atteberry, RN,
Patti Atteberry, RN, CRNI
Manager of Compliance and Risk Management
OSF Home Care Services
We check for a blood return with every bag change (on the CADD).  We also teach patients/caregivers to assess for a blood return, if one is not gotten, then they are instructed to call the nurse.  She will try to troubleshoot with repositioning, etc. if there still is no return, then a home visit is required to assess the line.  Our nurses are competencied on cathflo, therefore if needed the order is then obtained.
Hope this helps.
Patti Atteberry, RN, CRNI
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