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jadahl
Drawing blood from PICCs at time of insertion--yes or no?
Often times when we place PICC lines (usually in ICU or CCU), we are asked to draw blood from the PICC line during insertion for a STAT lab that they are not able to obtain from peripheral stick.  INS say PICCs are not to be used until tip location can be verified.  How do you handle this request?  Do you draw blood at time of insertion or do you wait until tip placement is verified?  Why or why not?  Thanks for your help.
lynncrni
I would not have a problem

I would not have a problem with drawing a blood sample at the time of insertion. You are aspirating for a blood return anyway. No CVC should be used for infusion until tip location is verified by xray though. 

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

www.hadawayassociates.com

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

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

daylily
Totally agree with Lynn. 
Totally agree with Lynn.  It is our practice to draw labs at the time of insertion, this is different that infusing before tip placement has been confirmed.
roger
We usually like to draw
We usually like to draw brood direct from the dilator at the time of first stick after the wire is removed.  Most if not all of these dilators have luer threads that allow for attachment of a syringe.  We like doing this because you can get those labs taken cared of right away and you can get the lab tech out and away of your sterile field, and also this blood is not going to be contaminated with any saline that you may have pre-primed your catheter with. Then we go about our normal routine of insertion without anybody hovering around us anymore.
Chris Cavanaugh
It is a good idea to draw

It is a good idea to draw labwork from the Introducer before inserting the PICC.  Some PICC kits come with a Luer slip syringe now, exactly for this purpose.

Chris Cavanaugh, CRNI

Chris Cavanaugh, RN, BSN, CRNI, VA-BC

Gwen Irwin
Like Lynn, we don't have a

Like Lynn, we don't have a problem drawing a blood sample at the time of inseriton.

We don't have a lab tech standing by, at all.  We hand off to the nurse who is wearing a mask and hair cover.

 Gwen Irwin

Austin, Texas

mary ann ferrannini
We also do this all the
We also do this all the time. We know it is in a vein and now that we use a tracking device we have a pretty good idea where it is,although we did it b/f we had a tracking device as well. As others have stated we do not use it until we get the CXR ane view it and release it to the nurse. I have to always myself what is best for the patient and what is the risk. The benifit is that you can draw your labs (often we are desperate for them) with virtually no risk for the patient.
mary ann ferrannini
We also do this all the
We also do this all the time. We know it is in a vein and now that we use a tracking device we have a pretty good idea where it is,although we did it b/f we had a tracking device as well. As others have stated we do not use it until we get the CXR ane view it and release it to the nurse. I have to always myself what is best for the patient and what is the risk. The benifit is that you can draw your labs (often we are desperate for them) with virtually no risk for the patient.
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