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PICCs and TPN

New adminstrators always bring up new questions.  Not a bad thing.  Somewhat annoying, but data fixes most things.

Here's the big one:  Anybody know of a contraindication for using a PICC line to administer TPN?  In my reading, I have never seen anything to support banning the use of PICCs for this.  All ASPEN and INS say is that the tip should be central.

I'd appreciate your input and any other references you may think of.

Now, for me:  How many are using heparin flush for locking central catheters?  We went to a PPD and saline only in 2006.  Our occlusion rates stayed stable for 2 years and then began to rise.  Education was repeated ad nauseum.  Now we are at the point that I have to seriously consider returning to heparin to save the lines.

Again, I'd appreciate input.

 

Thanks for your help.

lynncrni
 There is no contraindication

 There is no contraindication for infusion of PN through a PICC as long as the tip location is correct and confirmed and all nurses understand the s & s for tip malposition and what to do if those develop. 

There is no published evidence to support better outcomes with saline only for locking a CVAD. See statements in Infusion Nursing Standards of Practice, Flushing and Locking. This one was greatly expanded and contains lots of information about this. Heparin 10 units per mL remains the standard for locking all CVADs. Lynn

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

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