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Patti Atteberry
blood return for patency

Is everyone assessing for a blood return on PICC lines?  We do, but I am finding that several other facilities do not.  I instruct the nurses that anytime the line is accessed, it should be assessed for patency by obtaining a blood return.  Am I missing something?  I have had pharmacist request that we not do this, and area hospitals are not.  I have referred to the INS standards (68 practice criteria A).  I would like to know what other home care and hospital facilities are doing.

Thank you

KayBeth Weibel
Hi Patti, I am in home

Hi Patti,

I am in home infusion therapy and we always check for blood returns on PICCs, as well as all central catheters.  When we do not receive a brisk blood return, we address it with the physician and discuss Activase, then XR for tip confirmation if Activase is unsuccessful.  We don't teach the patients to check for blood return,  however.

 Take Care

Nina Elledge
We do the same as KayBeth

We do the same as KayBeth noted above


Nina Elledge, RN, CRNI

[email protected]

Nina Elledge, RN, MBA, CRNI

[email protected]

Patti Atteberry
Thank you both for your

Thank you both for your responses.  We are seeing an increased use of activase with the PICC lines.  Recently, we have been seeing the power piccs more often (5FR).  How much saline and heparin are you using?  What type of PICC lines do you see most often and what type of valve are you using?  I am trying to look at all of the angles.  I have had CRNIs and a rep state they have never heard of pulling back for a blood return.  I have to wonder if the hospitals are doing this, we have several come out of the hospital with occluded lines.

Thanks again for your assistance and have a happy holiday season.

Patti Atteberry, CRNI

Patti Atteberry, RN, CRNI
it is very important to
it is very important to check the blood return
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