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Ann Williams RN CRNI
vanco and other labs

I am interested in hearing what your practice is regarding Vanco levels, and other lab draws, thru a PICC line.  In our home situation, we have (for years) drawn labs from the lines.  In many cases it would be the only way to obtain the specimen.  I spoke with one of our ID docs years ago regarding this, and was given approval.  This same doc, "Dr. B", has recently had discussion with the hospital we are associated with, and is ADAMANT that no labs be drawn thru PICCs as "no matter how well flushed, some of the drug still adheres to the line giving false reports."  He also stated that this "is the practice in most major hospitals."  (to not use the line for labs).  The hospital is in the process of re-writing the policies based on "best practices" with what Dr. B is saying. 

I am looking for something to support our practice and offer to the hospital before they change their policy.  Or am I wrong?  We've only been doing it for probably 12 years!



This could be the same
This could be the same concept as drawing PTTs through a line where you gave heparin through. It is tough for home infusions especially if Vanco was decided after your line was already placed. What I started doing was screening the patient's meds, placing a dual lumen and dedicating one lumen for blood sampling and one for infusions for a known Vanco infusion.

Angelo M. Aguila, MSN, RN, VA-BC
Vascular Access Nurse
[email protected]

While I do not have a strict
While I do not have a strict policy regarding this, I personnally have always made every effort to avoid drawing any drug levels or coag studies through a line.  I have been a home infusion nurse for 20 yrs.  When you get high levels its always questionable whether they are real and its not so easy to redraw at home.   Most patient's will agree to a peripheral draw if explained this way.  I have tried to gently nudge my staff toward my way of thinking.  That being said, I wish I could stop all blood draws through the line except in extreme circumstances.  Presently, we only do this for physicians and hospitals who request we not draw through the line, but I am still preaching!

Carol Sweeney, CRNI, Vice President of Nursing & Clinical Compliance  ContinuumRx

Labs drawn from 'other" lumen of PICC

Is there a problem with drawing aPTT from the PICC lumen not being used for heparin infusion...if the heparin infusion is stopped for a short period first?

T. Nauman RN, CRNI

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