I am being told that outpatients should have their lines flushed with heparnized saline because they are more active, move their arms and muscles more which "pushes" the fluid out of the line causing more occlusions.Â
I am not sure I agree with this rationale- I try to avoid putting PICCs in weak or non-moving extremties because I thought the inactivity caused more thrombus and clots. Am I way off?Â
thank you.
No, not way off. Any extremity with any impairment of normal blood flow should not have a PICC placed in that extremity. However, all patients with a PICC should be taught to perform ONLY normal activities of daily living. This is not the time to do lots of weight lifting, or jobs that involve repetitive action. The reason for both precautions is the muscle pump action, also known as the venous pump action. Muscle contract to put pressure on veins causing blood to return to the heart. If there is a PICC inside that vein, the catheter can also be compressed, forcing the locking fluid out of the catheter tip. It really would not matter whether it was locked with saline or heparininzed saline, the muscle compression would also compress the catheter forcing fluid out and allowing blood to reflux into the lumen. When muscles are paralyzed, the normal pump action does not occur leading to an increase risk of thrombosis. So both no muscle action or too much can be a problem.
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