PICC line flush

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tineka in Fort Lauderdale, Florida

65 months ago

cynthia in Perry, Florida said: Yes you can flush a picc line as long as you IV certified.

exactly, with iv certification. I passed my boards 1 month ago.

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Timothy Christopher LVN in Dallas, Texas

61 months ago

I have been placing PICC lines and maintaining them for more than 5 years now. LVN's can place and flush PICC's. Use the old acronym SASH: saline, antibiotic, saline , heparin. Just flush the old heparin through with the first saline

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John Coxey in Syracuse, New York

61 months ago

LPNs are NOT ALLOWED TO TOUCH PICC LINES in NEW YORK STATE. It depends on your state board of nursing.

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HEDY in Columbus, Ohio

61 months ago

good morning, are we as aged nurses not being hired because we have gotten older. i have been an lpn for 21years and for the last 2yrs i have worked in casemanagement. but the problem is that i can not get a job here in the city where i live in ohio. i have notice that the trend is younger nurses are hired. can someone help me understanding?

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Rica in Indianapolis, Indiana

61 months ago

Frank in Raleigh, North Carolina said: I am a LPN at duke (which they call MLPN because we have extra training in med administration), and I am on the IV team there. I am able to do everything an RN does with the exception of pushing some classification of drugs, taking the role of charge, and insert PICC lines. I am able to flush and also trouble shoot simple picc issues/problems. The one thing that we here are also not permitted is taking out picc lines.
I have been a nurse for 13 yrs. and have flushed picc lines as well as drew blood specimens, and with the appropriate measures removed picc lines. You do have to be IV certified. Differences could be protocol of facility. Best to check with facility and state board.

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itsmecc in Tampa, Florida

60 months ago

Rudy in Union, New Jersey said: Anyone know about maintenance of a PICC line.

I have tried googling with mixed results.

Can an LPN flush the PICC? In any case do you pull out old heparin or just flush with 3cc of saline follwed by 3cc of heparin?

Your observations...

It depends on the protocol of your facility. I work at a hospital and we flush picc/perpherals/ CVL everyday on every patient and give certain meds even morphine but only up to 2 ml, We can't push dilauded only the RNS. We have a list on our walls what we meds we can pussh through IV's. You have to ask your facilty. but it is in our scope. We can't take them out or put them in. We can put in and out a peripheral though.

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Nikki in Chula Vista, California

59 months ago

ANNIE MAE in Palm Desert, California said: CAN AN LVN FLUSH A PICC LINE IN CALIFORNIA??

No we are not allowed to mess with a PICC line in Cali

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Suzanne in Fredericksburg, Virginia

59 months ago

Ok, in all of this I have not seen the answer to my question. I was asked to draw blood through a central line for labs this morning. I refused as I was uncomfortable with the thought of doing so even though I draw labs daily by inserting a needle in patients' veins. I THINK a central and picc line is the RNs' responsibilities but if I'm wrong and an LPN can draw blood for labs through a central line in Virginia, please let me know. Thanks.

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KAT in Arlington, Texas

59 months ago

ladyelectslp in Radcliff, Kentucky said: As a general rule , You can refuse to do any procedure that you are not comfortable with. I am a LVN from Louisiana and flushing and drawing blood from picc lines are not within our scope of practice. Texas is the same way. Did you learn how to flush picc lines and draw blood through picc lines in nursing school? If you did not. I would not do it. Because in the end, if something goes wrong it is your license on the line. Contact your state board and ask. Sometimes facilities will allow you to do things even if it is not within your scope of practice. Just say no and get an RN to do it. Yes , that is the RN responsibility. Its sad that they want you to do the work of an RN without the pay. Thats sad.

Texas allows LVNs to do IVP, flush and draw blood from PICCs. Here, it mostly depends on what hospital or facility you work at. I kind of disagree that you should just refuse do something within your scope of practice just because you didn't learn it in school. There is so much learned on the job that you don't necessarily do in school. As long as you are within your scope, your facility policy, and you have been properly trained to do it.

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itscocoa in Tampa, Florida

59 months ago

Right. I work at hospital and all LPNs flush PICC, central lins and Heplocks. it is in our Scope because the hospitl trained us. If not done you will be fired honey. every faciity and state is different.
Furthermore LPN school yo wont get rained on everything. We also place flexiseals which are rectal tubes in. Gtubes/ NGtubes back in yes LPN's we do it all. nothing is black and white. It's all up tp yor facility. I also push morpihine IV but only up to 2 ml. Now they tell you in school LPNs dont but like I said nothing is allways. There will always be exceptions. now we cant push dilauaid. We have a list of IV drugs we can push and how many millilters.There is a lot we do thhat I didnt think we could.
Dont go basing your judgement on everyones rules. It is differnt everywhere Faciiliy to facility. One facility cant but across the street they do.

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Brandy in Marshall, Texas

58 months ago

Rudy in Union, New Jersey said: Anyone know about maintenance of a PICC line.

I have tried googling with mixed results.

Can an LPN flush the PICC? In any case do you pull out old heparin or just flush with 3cc of saline follwed by 3cc of heparin?

Your observations...

i have had this conversation with many people and what i get is that a LPN cannot do anything with a picc unless you work for an angency that has specifically trained you in picc line care and i am trying to find somewhere to go take a picc line course and the classes are scarace

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itscocoa in Tampa, Florida

58 months ago

Lpns can do anything to a picc except insert and take out. But some facilities rules are do nothing to a PICC. Th erules are based on that facilitys protocol. At my Hospital we are allowed to flush Piccs and medicate and push some IV drugs even morphine up to ml. Dont go by what we do because you can get in truoble if your facility doesnt allow it. The rules are different everywhere you go. Honey there are no cross the board rules. Nursing homes have less thins they are allowed to do to.
You dont need a PICC LINE COURSE. i IS THE SAME care as Heplock whic is peripheral or CVL lines. Some facilities dont use Heparin to flush we dont. Some do. we only flush with normal saline before nd after. Some places use SASH saline ABT Saline Heparin. If they have Heparin then chances are they use it.We even draw blood from PICCs and CVL. We also draw blood from veins. You will learn the rules as you work different places. Try to not stay in only one facility for too long only. You will not know the difference of othher laces. I ave been a nurse for two years only. And I have been a lot of places I did the nursing home for one year with Agency onthe side. I do hospice. I am in the hospital and ICu/PCU medsrge on the side.. I get sent to different facilities with agency. I can work anyhere now. Even traveling. nurses think have been a nurse for long time because I have been exposed to a lot of different experiences and atmosphere.I love it.

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itscocoa in Tampa, Florida

58 months ago

Kim in Manchester, New Hampshire said: Under LPN's licensure we are not allowed to do anything to a PICC line.

not true everywhere . I work at the hospital an we do verythinhg with PICCS flush change the drssings. It depends where u work. We just caant insert or take out. Even push morphine baby up 2 m only thogh. Your facility rules are not applied to every facility remember that.

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Michael in Jeffersonville, Indiana

58 months ago

In certain states you can flush a PICC in Indiana you can...I flush piccs all the time...You have Power PICCs which you only flush with Saline...Then you have regular piccs which you flush with Heparin and saline...You start by drawing up your flushes 10ml of saline for each PICC Lumen...And 3 to 5 ML of Heparin as needed for each lumen...Then Wipe the lumen off with an alcohol pads then flush with Heparin if needed first...Then flush 5ml of saline then pull back on the plunger to see if you get any blood return which is what you want then flush the rest of the saline through if it does not flush or have good blood return you need to chart that then forward it on to a higher power...

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Dalnurse in Montreal, Quebec

57 months ago

jessie said: It depends on the state. I work in Ga. and LPNs do everything an RN does except initiate blood. However when I work in Tn. it is totally different.

Then what is the point of anyone paying all the money and getting a degree to be an RN in the states?

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KAT in Arlington, Texas

57 months ago

Dalnurse in Montreal, Quebec said: Then what is the point of anyone paying all the money and getting a degree to be an RN in the states?

Money, for one.

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JanelleRN in Youngstown, Ohio

56 months ago

Katiernx2 in Gaithersburg, Maryland said: A PICC line is NEVER flushed with any syringe smaller than 10cc. 5 or3cc will rupture the line and be very serious!

Ummm....I don't think so.....u better check that out. It's the force that YOU use when flushing that can rupture a line.

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JanelleRN in Youngstown, Ohio

56 months ago

KAT in Arlington, Texas said: Money, for one.

and....u don't stay young forever so think about the future in clinical management or whatever. they DO NOT take anything less than an RN BSN for most management situations - or even case manager for that sake. some hospitals don't even take less than a BSN to WORK THE FLOOR! wages make a big difference, too...depending on what u need, i guess

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lil2 in Denver, Colorado

55 months ago

Rudy in Union, New Jersey said: Anyone know about maintenance of a PICC line.

I have tried googling with mixed results.

Can an LPN flush the PICC? In any case do you pull out old heparin or just flush with 3cc of saline follwed by 3cc of heparin?

Your observations...

It depends on the state where you live. Go to your nurse practice
act policy of your state and it will give you that information, or
better yet you can call your local state board of nursing were you can also obtain this information. Lilly

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itscocoa@yahoo.com in Tampa, Florida

54 months ago

Honey it doesn't depend on your state. it depends on your facility. Each facility have different protocols. Some facilities use 3 some 5 some don't use heparin at all. Which my hospital we don't Kindred hospital we only flush with saline before and after. It's only our policy. So just ask your facility supervisor.

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itscocoa@yahoo.com in Tampa, Florida

54 months ago

Dalnurse in Montreal, Quebec said: Then what is the point of anyone paying all the money and getting a degree to be an RN in the states?

Being a RN is more than just flushing a line. You can insert midlines. LPN can't. You can get the blood from the blood bank. And there are a lot of other things you can do and we can only observe. Not a lot though. But you supervise us and get higher pay. In ICU LPN's we get 32 and RN's get 42. That's the sense of it all.

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itscocoa@yahoo.com in Tampa, Florida

54 months ago

Brandy in Marshall, Texas said: i have had this conversation with many people and what i get is that a LPN cannot do anything with a picc unless you work for an angency that has specifically trained you in picc line care and i am trying to find somewhere to go take a picc line course and the classes are scarace

Not true. I for the hospital. Not agency right nowIt just depends on what your facility allows. There is nothing black and white in nursing. Nothing in stone. What you learned in school sometimes in the real worlld the rules and laws get bent and parameters are put in place for convienience. Just ask your supervisor. No one here can tell you what your facility will allow.

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itscocoa@yahoo.com in Tampa, Florida

54 months ago

ladyelectslp in Radcliff, Kentucky said: As a general rule , You can refuse to do any procedure that you are not comfortable with. I am a LVN from Louisiana and flushing and drawing blood from picc lines are not within our scope of practice. Texas is the same way. Did you learn how to flush picc lines and draw blood through picc lines in nursing school? If you did not. I would not do it. Because in the end, if something goes wrong it is your license on the line. Contact your state board and ask. Sometimes facilities will allow you to do things even if it is not within your scope of practice. Just say no and get an RN to do it. Yes , that is the RN responsibility. Its sad that they want you to do the work of an RN without the pay. Thats sad.

Wooa You take that advice you will never get a job. There is a lot you were not trained on in school. Nursing is very wide and varied. the facility will train you if you ask. LPN's can flush and draw blood if in facility protocols. You can't insert or remove but we can certainly care for it change the dressing etc.

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JB in Oaklyn, New Jersey

54 months ago

Melissa Brouse in Shamokin, Pennsylvania said: I am shocked that an LPN cannot flush a PICC line. I am a parent of a six-year-old who was sent home from the hospital with a PICC line and my husband administers the meds. and flushes the line.

It is not that an LPN is incapable of doing picc lines. In has to do with scope of nursing practices. Also depends on certificates LPN holds and facilities protocols. At home you/we do not have to worry about that and or being SUED.

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JohnInNY in Syracuse, New York

54 months ago

Better worry about loosing your Nursing License as well.

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icm in Austin, Texas

53 months ago

tim in Fort Worth, Texas said: This is not true LPN's can flush and even insert picc's.

incorrect, according to the texas board of nursing, lvn are not able to insert picc lines ever, regarding of training. Administer meds its okay as long you have been trainned by the facility you work for

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bebe in Bronx, New York

52 months ago

It doesn't matter WHAT your facility says.

IF THE BOARD OF NURSING SAYS "NO" the answer is NO.

Your facility does not give you a license, but they can help you LOSE IT.
(They CANNOT help you get it back)

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S. Robinson in Cleveland, Ohio

50 months ago

In Ohio we're not permitted to flush or do anything to a PICC line only monitor it which sucks cause I am I.V. certified and hardly get the chance to utilize my skills.

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christi,rn in Oklahoma City, Oklahoma

49 months ago

LPN's can not draw from at picc line and they may flush one. Doesnt matter how many yrs you have under you. There are certain things an LPN cant not do in the state of oklahoma. Actually the state is doing away with LPN's. RN is the main word.

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lynn H. in Saint Louis, Missouri

46 months ago

I work in the state of Missouri, LPN's if trained and following facility or companies protocol, according to state board of nursing can Maintain the patency of "locked peripheral and central venous catheters with saline and /or heparin solutions. change central venous line administration set tubing and site dressing . Obtain blood specimen for laboratory testing from established central venous catheters which include implanted vascular access port devices that have already been accessed. LPN can not under any condition, administer anti-neoplastic drugs, begin the initial transfusion of blood, access the port reservoir, perform intravenous admixture which a syringe/need;e is used to add drugs, add drugs to fluid container, remove a mid line catheter or any type of central venous catheter, participate in any intravenous infusion treatment modility involving neonates.

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CM in Bryan, Ohio

45 months ago

Katiernx2 in Gaithersburg, Maryland said: A PICC line is NEVER flushed with any syringe smaller than 10cc. 5 or3cc will rupture the line and be very serious!

Yes....you are correct! NEVER use anything smaller than 10 ml syringe.

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RN in Tyler, Texas

45 months ago

HLS in Corona, New York said: SASH is utilized for PICC lines that are in use. As for the being flushed weekly this is done in conjunction with the weekly dsg change for PICC lines that are in and being kept patent while nothing is infusing through it.

If you have a double-lumen PICC and only one is being used, say for antibiotics, and you just want to use the other for labs draws, you must flush the unused lumen daily with NS et Heparin.

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Jenn in Steubenville, Ohio

45 months ago

Cindy in Steubenville, Ohio said: LPNs in West Virginia cannot do IV PUSH medications, but we CAN flush all lines and do. Using the SASH method for everything except a Groshong which uses no Heparin. We are not permitted to ACCESS a Mediport, but we can flush and set up IV lines. We are NOT permitted to pull any kind of line. As my collegues have stated here, check the guidelines for your individual state.

Lpns can iv push meds in wv with limitations. it is within the scope of practice set by the wv state board of nursing-pn

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Nurse Rambo in Georgia

42 months ago

Geriatric NP, 6 yrs ICU, 14 yrs total. No one can exceed the scope of practice determined by the state you practice in. No facility can (or should) exceed or ask you to exceed the state scope of practice. A facility/superior can further limit your scope of practice, but cannot extend your practice beyond state limitations.

Hints on flushing piccs: at the end of SASH, before the heparin syringe is removed from the valve on the end of the picc line, ALWAYS clamp the picc line before removing the heparin syringe, the last syringe in cases where heparin is not used. When a syringe is removed from ANY line, a valve shuts on the line. When the valve shuts, it sucks (aspirates) a little blood into the other end of the picc line (or any line for that matter.) Heparin reduces the chance of clotting. Clamping the line before removing the last syringe further prevents clotting. They don't teach that in school, not taught by product providers, but will reduce the incidence of clotted lines, picc's included. This is particulary important when not using heparin! Now, where's my five bucks?

It blows my mind that families can be instructed to home infuse, but LPN' cannot in some states???

FYI: We find granny with a UTI (urinary tract infection) at home, the PCP (primary care physician) can't see granny for 2-3 days. Granny gets totally delerious and goes to the ER for an IV antibiotic and hopefully sent home. Cost? $7,000 at every ER across the US. $7k billed to Medicare. The UTI could be handled at the MD's office, local urgent care, or at home for a few hundred dollars. So, why the $7k tab at the local ER who MUST treat everyone walking in the door? INDIGENTS, legal and otherwise. Blame Granny? We throw the elderly under the bus for excessive Medicare costs... guess who's riding in the bus with the politicians and media? Think about it every time you hear how the elderly are driving up Medicare costs and breaking the financial back of America!

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Nurse Rambo in Georgia

42 months ago

BTW, you can get a hundred Bactrim DS (UTI Abx) for about $2.50 in Mexico WITHOUT a prescription! You can get a doctor on-line in the US for $35 per diagnosis/prescription faxed to your local pharmacy. Antibiotics are shipped in from Canada for pennies on the dollar. There may be some concern for quality from Canada, but shipped from a US distributor??? I'm concerned about the quality of what's at the local pharmacy! Granny goes from one UTI to the next, to the next... Have a bottle of Abx on the shelf, rotate antibiotics to prevent drug resistance, always consider allergies, renal clearance. Get some online instruction on recognizing a UTI. ALWAYS, ALWAYS consult your doctor for medical advice. Always remember that going to the ER... $7K if you pay 'payroll' taxes.

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Marian Montana in South Beloit, Illinois

40 months ago

Rudy in Union, New Jersey said: Anyone know about maintenance of a PICC line.

I have tried googling with mixed results.

Can an LPN flush the PICC? In any case do you pull out old heparin or just flush with 3cc of saline follwed by 3cc of heparin?

Your observations...

In Illinois I know for a fact that LPN's are not allowed to flush PICC lines. You can do dressing changes to the site, but that is as far as it goes.

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Marian Montana in South Beloit, Illinois

40 months ago

tim in Fort Worth, Texas said: This is not true LPN's can flush and even insert picc's.

NO LPN can insert a PICC line....that is foolish for anyone to say that. ONLY A DOCTOR can insert a PICC line. I don't think you know what a PICC line is if you think you can insert one. Better read up on a PICC line.

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IV Nurse in Tyler, Texas

40 months ago

I see lots of misinformation regarding IV therapy--How about a course to refresh your knowledge on the most current IV standards from the Infusion Nurse Society.

www.pedagogy-inc.com has the largest selection of IV education courses. For those with Scope of Practice questions the "Resources" section on the website has links and references to each states Board of Nurses, along with "Position Statements" on the boards position of LPN/LVN's practice of IV therapy. The resources section also has a lot of useful IV reference materials for you use.

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richard taylor in Corinth, Mississippi

39 months ago

tiye said: I'm a lic. LPN living and practicing in Las Vegas Nv, I would suggest that you go back and look into your state laws because each state is different the nursing laws that govern LPN duties. In Las Vegas LPN do not manage PICC or Flush PICC 2nd PICC lines are never pulled out only by Certified RN's or Specialist definitely not LPN. Again check your state board of nursing and facility protocol. Good luck in your. Tiye'

YEAH A 45 year old with 15 YEAR EXPERINCE L.P.N WOULDNT HAVE A CLUE ON HOW TO PULL out A LINE WOULD THEY???? versus a RN that 20 years old with maybe 6 months experience!!! in this state its all about kicking up to the board about it.there has to be something to separate a LPN versus a RN. if not they would have to merge names. see the nurse practitioners here all got together and started whining till the board allowed them to write schedule II drugs. {which is very dangerous}. we LPN`S don't care if the RN wants to push drugs,IV`s VAD`s etc. we keep quite!! just less we have to do. YES SIR Ive done EVERYTHING a RN CAN and does plus alot more! when your the only person around {in a nursing home at 3am} and somebody is dying, you do what you have to do.

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Theresa in Portland, Oregon

35 months ago

Marian Montana in South Beloit, Illinois said: NO LPN can insert a PICC line....that is foolish for anyone to say that. ONLY A DOCTOR can insert a PICC line. I don't think you know what a PICC line is if you think you can insert one. Better read up on a PICC line.

I am an RN CRNI (certified RN infusionist) and VA-BC . Usually only trained RNs place PICCs, not MDs.
***never, ever use a 3cc syringe on a PICC - ever!*** This could cause embolism to a patient - very serious consequence!! or balloon - weakening the exposed prtion causing it to rupture. Often the PICC then is destryed - this proceedure is costly. I peripheral IV costa about $2.00 - $6.00. The is ore costly - has to be exrayed in some places (if not using EKG tecnology), the kits are aobut $300. averging about $700 - $1000 of destruciton, plus risking safety, expese of a new line, missed medications that have to be exteded now, etc. There are other things you should be trained to do that are very simple, but if neglected can destry the PICC, intefereing with therapy, prolonging the patients hospitalization if the pt has to wait for a new PICC to be placed, ect. You could interfer with therapy, if flushing protocol is not met, it could cause the line to become disfunctional or even risk causing a serious blood stream infection. (bacteria can be introduced to a line by the person handling it, blood clots can attract more bacteria, esp on someone that is very sick and fraile). Best practiced is that anyone (LPN, Staff RN) that uses a PICC should be trained on how to draw and flush a PICC. It is easy to ask your manager (your advocate), charge or experienced co-worker if you have a question. I am guessing since you are not aware, then you were not trained to draw. You should have been given a packet with policy and procedure at hiring. Also, every hospital makes policy proceedure available, often on-line or a binder somewhere obvious. Good idea to know how access it.

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33yr RN.... in Dallas, Texas

35 months ago

Mama Rosa in Atlanta, Georgia said: SASH----Saline-Antibiotic-Saline-Heparin.
PICC Line not use-Flushed with 3cc saline/weekly

Rn
Saline
Antibiotic
Saline
Heparin
unused line flush with Heparin
to prevent PICC line from clotting

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Monique in Marlette, Michigan

30 months ago

No Name in Jackson, Michigan said: It is against protocal for an LPN to flush a picc in Michigan. Facilities want you to do this, but will not take the responsibilty if something goes wrong. I wouldn't if I were you.

I have flushed numerous PICC Lines during my nursing career and administered IVPB meds through them as well....I've been an LPN for 11 years. I've never encountered any problems. We always flush with the SASH method--saline (10ml pre-filled syringe), med, saline then Heparin (10ml pre-filled syringe.) I live in Michigan and work in long term care.

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RNrose in Salem, Ohio

10 months ago

Rudy in Union, New Jersey said: Anyone know about maintenance of a PICC line.

I have tried googling with mixed results.

Can an LPN flush the PICC? In any case do you pull out old heparin or just flush with 3cc of saline follwed by 3cc of heparin?

Your observations...


I have been an LPN and then went on for
My RN. It doesn't matter what your facility says, it matters what your scope in your state allows. In Ohio, Lpns cannot touch a picc or central line. That can't ever push any drugs through any IVs no matter what line it is. They are only allowed to insert peripherals and maintain fluids that have already
been initiated by an RN, ie) saline, lactaided ringers, etc...

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