We had a patient with a low blood glucose and could not put in the amp of D50. The PICC was working well, both ports did have blood return and flushed easily w a 10cc syringe. Would we expect this to happen, or was this an incidental occurance?. I am thinking possibly we could have anticipated this ?? related to viscosity? The nurses also injected an amp of bicarb, so they do not think it had to do with the larger syringe size. PLEASE ADVISE, especiallty would like advise from a larger PICC service
thanks
I can only assume that you were trying to push the D50 from a syringe and you met so much resistance that it would not flow in. Or were you trying to infuse from a bag? By gravity or on a pump? All of these factors make a difference.
D50 is highly viscous so that added to the resistance to flow. The length of the PICC also added resistance. I can see where the viscosity and length would have greatly impeded gravity flow. I have seen this lots of times when trying to infuse blood through a PICC. A pump with a very low occlusion pressure may not have been sufficient to overcome the resistance from both of these factors either. A 50 mL syringe is very large, and the size and strength of a nurses hands comes in all varieties. This large syringe with a smaller hand, plus the viscosity and catheter length could have added up to so much resistance and not enough force to overcome that resistance.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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
Angelo M. Aguila, MSN, RN, VA-BC
Vascular Access Nurse
[email protected]