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lseaver
lab draws from power PICC solos

I do have a couple of questions for you regarding the new solo power PICCs. 

Have there been any complaints about “contaminated” labs drawn using these lines? By contaminated, I am referring to contamination by dilution of IVFs/meds left in the 3-way valve area after flushing with 10 of NS and aspiration of 5 cc waste, is there any chance that fluid in that valve area has not been flushed out well, and might be affecting lab values.  We have suddenly had a onslaught of erroneous labs drawn and the nurses are pointing to the power PICCS here while lab thinks that fluids have been left running during the draws.    We have had results of K+ of 19, and glucose leves that were 1000+ from the line draw vs 124 from the peripheral redraw.  The solos are the ones I am wondering about, because of that round reservoir containing the valves at the entrance to the line.

If you have any insight or information regarding this, please let me know.

Thank you,

Lesha Seaver RN

IV Team, Liberty Hospital, Liberty, MO

lynncrni
I have not heard of any

I have not heard of any complaints of this nature yet, but you should direct your questions to Bard Access. The Solo valve has one valve for infusion and 2 other valves oriented differently for blood aspiration. It is too new to have any publications about it yet.  

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

mary ann ferrannini
 We have placed about 150
 We have placed about 150 or so and have not had this problem. I would investigate how the nurses are drawing the labs. We have done training for years and it in ongoing on how to properly draw blood from all types of CVCs and especially multi-lumen lines. Many nurses do not understand how a multi-lumen catheter is configured and would leave IV fluids running.or shut them off only for a second or two,leave something running downstream,not perform a proper discard or worse yet mix up the samples and have the discard tested. Also with a high K+ level one would expect that the intracelluar potassium was released. This is usually caused by a too rapid withdrawl of blood. Slow and steady wins the race on blood withdrawl from a PICC. If the syringe vibrates you are pulling too hard. Ask the nurses how they are performing this task just to see if there are other causes. It could be the valve but it seems unlikely to me since PASV also has a vavle (though a bit different) in the proximal tails of their PICC and they have not had any issues. Keep us informed
Keith Lepsch
I had similar problems with

I had similar problems with BSCI PASV PICC and it was always that the IV's were left running durring the draw.  Remember that the PASV and the SOLO both have side by side lumens and not proximal and distal.  This problem can probably be solved by education.

1) turn of ALL IV's to all ports for one minute

2) Flush with a pulsitle technique and 10cc NS always 10cc or bigger syringe

3) draw your waste (you can keep your flush syringe attached and draw the waste with the same syringe)(I teach 10cc waste, to keep the numbers simple, everything is 10cc and if your drawing coags you need a 10cc waste anyways)

4) draw your sample chem, cbc, coags

5) flush with 20cc

 

Keith

 

Heather Nichols
  The summer before last we

  The summer before last we had complaints from our lab that the lab draws from PICC's were way out of wack. The lab wanted us to ban lab draws from PICC's!  After some careful chart review, and review of our data that we collect daily on our PICC's, we found that this had happened over a change in PICC's.  We re-wrote our flushing policy, did several weeks of education on it, and it disappeared.  We also inadvertantly cut down on clotting problems with the triple lumen central catheters.  It is probably an education issue that Bard could solve for you.  Lynn is right.  Call Bard for help with this.  We trialed the SOLO, and there were complication, but this was not one of them.

Heather 

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