I know that you can't use anything smaller than a 10cc to inject into a picc line but is there anything out there about using a smaller (3cc syringe) to draw off a picc line. I had been taught that drawing off a line with a smaller syringe could cause the line to "collapse". Any truth to this? Thanks in advance!
You have been taught wrong! The new standards and guidelines now state that the patency of all VADs, including PICCs, is assessed with a 10 mL syringe. If it is open and patent, as evidenced by no resistance to flush and a blood return the color and consistency of whole blood and there is absence of all signs and symptoms of complications, all medications and flushes should be contained in a syringe that is appropriately sized for that dose. This means you can use a 3 mL syring on a PICC to give a medication if that is the best size for the med.
On aspiration, smaller syringe sizes are better because they can exert less pressure inside the lumen. Even if a large syringe causes occlusion of the VAD, it is temporary and will reopen once the negative pressure is relieved.
Download this paper from ISMP for information regarding syringe size. www.ismp.org/Tools/guidelines/IVSummitPush/IVPushMedGuidelines.pdf
Also, the current (2011) and the new (2016) INS standards state to use the syringe size appropriately sized for the medication being given after patency assessment with a 10 mL syringe.
Lynn
Lynn Hadaway, M.Ed., RN, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thank you so much Lynn!
Thanks for this posting. I was asked this question at my work by a pediatric nurse. The INS standards say to use no smaller than a 10cc syringe to flush but does not say that a smaller barrel syringe cannot be use for medications. I see this in the pediatric population a lot as their doses are of smaller volumes.
David Dempsey MS, RN
The truth is that just the opposite is true with aspiration - the smaller the syringe the less the pressure. So for example when unable to withdraw a blood sample switch from a 10 to 5mL syringe. You will probably be successful.