Double-lumen PICC lines come in two colors. Red is the blood access lumen or arterial lumen and blue is the blood return lumen or venous lumen. Despite the names, neither lumen is leads to an artery, but both lead into a vein.
Why not use the PICC for the blood draw?
You can run almost anything on the other lumen when running TPN. You just can't run anything on or draw blood from the lumen that the TPN is connected to. It is just too high of an infection risk! Plus if they get the infection the hospital doesn't get paid for treating the infection.
No
proximal port
Yes, you can use it.
Based on information found in nursing forums it is agreed that either lumen can be used in a double lumen picc line for the infusion of antibiotics although it is recommended that it is advised users check with the manufacturer of the catheter before administering medication through it.
Usually you do not draw blood from a line that is running TPN due to the concentrated electrolytes contained in the solution. If there is no other option the MD must be aware that the sample is taken from a TPN line so he/she can adjust the findings ANOTHER VIEW: PICC lines and other central access devices were not designed to have blood drawn from them for Lab tests. Specimen contamination is a serious problem for Lab whether the specimen is drawn from a single or double lumen PICCs. Even if the other lumen's infusion is shut off, the vacuum created in the lumen where blood is being drawn can cause contamination of the specimen. Often, even if the lumen is flushed properly and there is no contamination, the specimen may be hemolysed or clotted, making it useless for lab testing. In general, Lab will not report out results that they suspect are erroneous. This is because a Lab tech or physician cannot simply "adjust" findings due to an improperly collected specimen. This would be guesswork and is unacceptable in a health care setting where treatment often depends on reliable Lab results. Bottom line: check your facilities' policies and procedures regarding the use of PICCs and other central access devices for blood collection.
Yes
Yes, provided that you "pause" the infusion of heparin prior to taking your lab sample. Also, prior to drawing back blood from the PICC line infuse 10cc of Normal Saline and then draw off a waste of 10cc of blood. It is also suggested that you draw off another 10cc of waste blood prior to drawing the Hep APPT. Then draw your sample for the Hep APPT. There should not be any problems with the sample. Remember to do a final flush of the PICC line with 2 X 10cc of Normal Saline. Guy L Yes, provided that you "pause" the infusion of heparin prior to taking your lab sample. Also, prior to drawing back blood from the PICC line infuse 10cc of Normal Saline and then draw off a waste of 10cc of blood. It is also suggested that you draw off another 10cc of waste blood prior to drawing the Hep APPT. Then draw your sample for the Hep APPT. There should not be any problems with the sample. Remember to do a final flush of the PICC line with 2 X 10cc of Normal Saline. Guy L
No as a PICC goes into a blood vessel and any foreign object could be fatal.
As soon as you get the test results back from the culture you have the okay to insert the picc line.