Hello I am not sure if this question has been answered or not but I really like to hear from other nurses and I am getting conflicting answers. I have a patient that has a power picc 4Fr dual lumen Solo. She was told by different nurses to use the red caps at the end of the tubing in order to protect bacteria from getting inside. I have seen the green caps and there are red one also she was told to cap it and not clamp. I know these are made if you cap it doesn't it de pressure it and can actually cause more harm? The last one was pulled and she cap them with the red caps you would use on your IV tubing after you prime it.
I like to hear from others, I just finish nursing school and are new to Picc lines. also each picc line she has she has broken out in weeping blisters, we are currently using mexplex border on it to cover it and using the no sting skin prep and Optsite to go over it as it doesn't stay on the full 7 days, we use a cathguard to hold each of her tubing in to protect it . Is there anything else we can do to prevent the blistering when it gets bad? The tubing exten has a Clamp but the hospital said take it off.
If anyone could help me out I would appreacite it
Starr Andrews Strong
All VADs of all types absolutley must remain closed. This is accomplished in 2 ways. For continuous infusion, the administration set should be attached directly to the catheter hub and remain connected until it is time to change that set at 96 hours. For intermittent infusions, all VADs should be closed with a needleless connector to facilitate easy connection without opening the catheter and without the use of needles. A red cap is a solid cap and NOT a needleless connector. This cap is used to cover the male luer end of an IV administration set that is to be reused for an intermittent medication. When you refer to the green caps, I think you are actually meaning a disinfection cap - one brand is bright green. This cap contains alcohol and is not indicated to place directly on an open VAD hub. It is placed on top of a needleless connector to protect it from contamination between uses and to disinfect it. There is good evidence to support the use of disinfection caps, but not directly added to the VAD hub. The weeping blisters on the skin surrounding the insertion could be from many different causes. This is now known as medical adhesive related skin injury and there are several causes. Prevention begins with ALWAYS using skin protection solution before each dressing, even the very first dressing after a VAD is inserted. All solutions must be thoroughly dry before a dressing is applied. And the dressing must be applied in the manner contained in the dressing instructions. Sometime stretching the dressing can cause skin damage also. It sounds like you might need to work with a wound care nurse specialist to heal this present site and prevent it from happening again. You also need to obtain a copy of the Infusion Therapy Standards of Practice from the Infusion Nurses Society and learn its contents. There are also several infusion therapy textbooks with all this information. Good luck with your patient and your learning process. And congratulations on becoming an RN. Welcome to our world!! Lynn
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
I forgot one important point. All CVADs should be clamped when there is nothing infusing through them. This is a safety mechanims to prevent accidental disconnection that could lead to air embolism, which can cause death or severe disability. Many times the needleless connector is clear along with the clear IV set. The nurse can not tell what should be disconnected and what should remain connected. Anytime a CVAD is opened, you must have the patient lying flat and either asked to perform a valsalva manuever or at least hold their breath while it is open to prevent air from entering the line and bloodstream. The red and green caps you mentioned attached directly to the CVAD hub would mean the line is opened every time it is used for infusion. The needleless connector prevents this opening from happening. Lynn
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