Submitted by Corey Mertz, PICC line specialist RN, Willamette Valley Medical Cent on Wed Jun 16 17:35:32 2010
Should blood return be checked prior to using PICC line & or Central Line every time? I've heard this comes from INS, but had difficulty locating this in the standards of care.
I guess the risk is a large fibrin sheath(sock) may form over the entire catheter and the medication/vessicant can track back to the site and the subcutaneous tissue. I have a hard time believing this can happen to a PICC line and find the potential for increasing risks of clogging/infection and flushing non-compliance by doing this more than once every 24hrs.
What are the policies/practices of other facilities? Is it standard practice verifying blood return from central lines prior to every medication infusion/fluid start and to initiate thrombolitic protocol when blood return isn't possible? Also, are you routinely getting CXR's to re-verify tip placement when unable to get blood return?