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 I would have the PICC flushed at least once per 24 hour period. There is no evidence to support leaving it longer without flushing and locking. In this case there is no heparin to enhance to the risk reduction of lumen occlusion due to blood reflux. Arm movement and muscle contraction can compress the catheter causing the lock solution to move into the bloodstream and the blood to move into the lumen to replace the lock solution. Think of what happens when you pinch a fluid filled straw. Waiting several days can increase the risk of total occlusion. There are ambulatory clinics flushing once per day now, but I don't know of any that are allowing for longer periods. As I said there are no studies on this issue, so you just have to benchmark against the practice of others. I am interested to know if there is any clinic allowing for several days between flushing and locking. As you stated, you can avoid this whole situation by having the PICC removed as it is no longer necessary for care. Lynn

We were told by Bard that the power piccs should be flushed with 10 cc NS after each use or once a week when not in use/ when the CLC2000 caps or equivalent are used.

We were told by Bard that the power piccs should be flushed with 10 cc NS after each use or once a week when not in use/ when the CLC2000 caps or equivalent are used.

We have been using the Solo Power Piccs by bard for several years now.  One of the main reasons we picked those lines is due to the low maintenance and need for only flushing weekly if not used.

We wanted it to be low maintenance, where if for a short period of time the patient wasnt coming in each day they would not have to do any accessing of the line. We send them home with the line wrapped in kerlex/fluff and then a stockinette over it.    We have several patients where we have been treating them with antibiotics for a cellulitis and then antibiotics stop but we may opt to keep that PICC a week or two to be sure they stay out of the hospital and then arrange for removal of the line if not re admitted.  We pulled lines on the last day of meds in the beginning and we had pts who we pulled there line and then they returned a weelk later to start treatment again.  We also have pts who are getting blood transfusions regularly and have a picc line.

This has worked well without any untoward events. No increase in occlusion rates noted etc. Of course, I did not do a formal study or even keep notes, since I was expecting all to be fine since we were following manufactures instructions.    Most of them we will schedule to come for the dressing change and flushing of lines and cap changes weekly.  Some of them have home health maintane it for them.   We usually only keep them a week or two and then if they are not actively being used we remove them. 

I definitley see how Lynn makes mention of getting clinical documentation to back up their statements.   But,  even at the hospital, for inpatients, we are only flushing lumens on PICCs or physician inserted central lines before and after each use, not each shift or even every 24 hours for all lumens. 

I certainly do my share of Cathflo for occlusions but.....these are usually the lines that are being used actively .

Just a note to let you know how we are doing it here at our facility.  Once again I agree with the idea of getting literature to back up decisons or recommendations made.  I will certainly make that a standard from now on.  However,  I am quite pleased with how the current regime is going with flushing of lines  per manufacture recommendations. 

Gina Ward R.N.

Could you please point me to references as to NS only flushes (except unused PortaCath) and those with NS&Heparin flushes. I thought NS was best, to avoid HIT