The chapter includes background information section 2. Also try not to draw blood from the port that the tpn is running through. If tpn is infusing, stop infusion and flush with 20 ml normal saline. What i do is turn off all the infusions that i can obviously inotropes stay on.
If your patient has a central line that is a double or triple lumen, then you can use one for tpn which is dedicated. Blood cultures, line draws akron childrens hospital. The tpn line should not be used for any other purpose. Contact lab is unable to collect the minimum specimen volume.
Forgot to stop tpn before drawing blood from central line. Place a sterile fillneedle on the end of the syringe of blood. Used for recovery that last for line for tpn, one for iv medsflush, one for lab draws. If peripheral draws are too difficult andor the pt needs other meds in addition, we use a triple connector to maintain a closed system.
How you can draw blood at askives can you draw blood from a doublelumen picc line which is used primarily for tpn. Tpn and blood transfusions lounge allnurses breakroom. Total parenteral nutrition tpn nutritional disorders. I always hold tpn and any other infusion that might affect my electrolytes for several minutes when drawing from a picc or other central venous line. It is intended to teach the principles of line care, but not intended to be an instructional video. Phlebotomy tips from the pros when drawing blood, right before the actual stick, i ask the patient to take a deep breath. Clean bottle top with 70% isopropyl alcohol and allow to air dry.
Flushing and blood withdrawal from a central line youtube. A place to discuss the topics of concern to the nurses of reddit. The information given in this section underpins that given in the remainder of part. If you remember what you learned in school, if you had 5% glucose infusing and were going to use the same site for blood, always flush the line first with normal saline to remove any glucose.
A central venous catheter cvc, also known as a central line, central venous line, or central venous access catheter, is a catheter placed into a large vein. Draw required volume no discard from each central line. The method that i have personallly found the best is to stop all meds running through the line, and to use the pushpull method. If resistance is felt with flush, see infusion therapy central venous catheter. The type of cvc inserted depends on the emergency and necessity of the iv line.
Although the safest and most accurate way to draw blood for lab work is via peripheral veins, you may need to draw blood through a central venous catheter cvc if the patients peripheral veins are no longer accessible. Some of these include vasopressor infusions, longterm medication or fluids, chemotherapy, longterm nutrition, repeated blood draws, and dialysis. Pull back plunger and withdraw 5 ml of blood for discard. When drawing blood from a double lumen picc line, which has tpn running do you 1 flush with 10mls of normal saline, pull back 10mls of blood discard and throw that away before taking your sample. One line for tpn, one for iv medsflush, one for lab draws. Press question mark to learn the rest of the keyboard shortcuts. This chapter covers all the steps recommended for safe phlebotomy and reiterates the accepted principles for blood drawing and blood collection. A central venous catheter cvc is inserted by a practitioner for a variety of reasons. There is no logon required to view procedures, so nurses and clinicians quickly get to the information they need. External tubing should be changed every 24 h with the first bag of the day. Bear in mind that when you do so, you increase the risk of cvcrelated complications, such as occlusion and infection.
Lippincott procedures is a webbased tool and can be accessed via the internet from within your organization via ip authentication, athens authentication, or referral access. Placement of larger catheters in more centrally located veins is often needed in critically ill patients, or in those requiring prolonged intravenous therapies, for more reliable vascular access. Blood draws from central lines with tpn infusing iv. Because the central venous catheter needs to remain in place for a long time, strict sterile technique must be used during insertion and maintenance of the tpn line. This video has been made to demonstrate proper flushing and blood withdrawal from a central line. Registered users can save articles, searches, and manage email alerts. The method that i have personallly found the best is to stop all meds running through the. There is a higher risk for infection when you pull blood through the same port. Central line insertion and how to draw blood from new to icu.