Drawing blood from a peripherally inserted central catheter (PICC) line is a vital nursing talent. PICC traces are lengthy, skinny tubes which can be inserted right into a vein within the arm and threaded as much as the superior vena cava, a big vein close to the center. They’re used to manage drugs, fluids, and blood merchandise, and to attract blood for laboratory testing. Drawing blood from a PICC line could be executed safely and successfully by following the correct steps.
Earlier than drawing blood from a PICC line, the nurse should first confirm the affected person’s identification and the order for the blood draw. The nurse ought to then collect the required provides, together with a tourniquet, gauze pads, alcohol wipes, a syringe, and a blood assortment tube. The nurse must also put on gloves and a robe to stop the unfold of an infection.
As soon as the provides are gathered, the nurse ought to clarify the process to the affected person and procure their consent. The nurse ought to then place the affected person in a snug place and apply a tourniquet to the arm above the PICC line. The nurse ought to then clear the insertion website with an alcohol wipe and permit it to dry. The nurse ought to then maintain the syringe in a single hand and the blood assortment tube within the different hand. The nurse ought to insert the needle of the syringe into the PICC line and aspirate the blood. The nurse ought to then switch the blood to the blood assortment tube and take away the needle from the PICC line. The nurse ought to then apply stress to the insertion website with a gauze pad and take away the tourniquet.
Gathering Tools and Getting ready Supplies
The preliminary step in drawing blood from a PICC line is gathering the required tools and supplies. To make sure a easy and profitable process, it’s important to arrange all of the required objects meticulously.
### Important Gadgets
Syringes: Choose a 10-mL syringe for amassing the blood pattern and a smaller syringe (3-mL or 5-mL) for injecting saline flush earlier than and after the blood draw.
Needles: A 22- or 23-gauge butterfly needle or a blunt-tipped Huber needle is often used to entry the PICC line.
Alcohol swabs: Alcohol swabs are used to wash the injection website and the PICC line hub.
Gauze pads or cotton balls: These are used to use stress after the blood draw or to soak up any spilled blood.
Tape: Tape is used to safe the butterfly needle or Huber needle throughout the blood draw.
Blood assortment tubes: The tubes ought to be labeled with the affected person’s info and the kind of blood pattern being collected. Be sure that the tubes are vacutainer tubes for correct blood assortment.
Saline flush: Saline flush is used to clear the road earlier than and after blood assortment to stop clots and preserve the patency of the PICC line.
Private protecting tools (PPE): Gloves and a masks are important for an infection management throughout the blood draw process.
| Merchandise | Amount | Function |
|---|---|---|
| 10-mL syringe | 1 | For amassing blood pattern |
| 3-mL or 5-mL syringe | 1 | For injecting saline flush |
| 22- or 23-gauge butterfly needle or blunt-tipped Huber needle | 1 | For accessing PICC line |
| Alcohol swabs | A number of | For cleansing injection website and PICC line hub |
| Gauze pads or cotton balls | A number of | For making use of stress or absorbing blood |
| Tape | 1 roll | For securing needle |
| Blood assortment tubes | As wanted | For amassing blood pattern |
| Saline flush | 1 vial | For clearing PICC line |
| Gloves | 1 pair | For an infection management |
| Masks | 1 | For an infection management |
Establishing Right Affected person Identification
Correct affected person identification is essential to make sure the right affected person receives the suitable care. To determine appropriate affected person identification, observe these steps:
**1. Examine the Affected person’s Identification Band:**
- Confirm that the affected person’s title, date of beginning, and medical report quantity match the knowledge on the identification band.
**2. Ask the Affected person to State Their Identify and Date of Start:**
- Ask the affected person to verbally affirm their title and date of beginning.
- If the affected person is unable to speak verbally, check with the affected person’s chart or medical data for affirmation.
- If there are any inconsistencies between the affected person’s acknowledged info and the identification band or medical data, confirm the affected person’s identification utilizing further identifiers comparable to a photograph ID or fingerprints.
**3. Evaluate Bodily Traits:**
- Word the affected person’s normal look, together with top, weight, and facial options.
- Evaluate these bodily traits to the affected person’s medical data or a photograph ID to make sure they align.
- If there are any discrepancies between the affected person’s bodily look and the recorded info, additional investigation could also be obligatory.
**4. Doc and Repeat Verification:**
- Doc the affected person’s identification and the strategies used for verification.
- Periodically repeat the verification course of, particularly when administering crucial drugs or throughout high-risk procedures.
Adhering to those steps helps guarantee correct affected person identification and reduces the danger of errors that would compromise affected person security.
Accessing the PICC Line
Accessing a PICC line is a comparatively easy process that may be carried out by a educated healthcare skilled. The next steps define the method:
Getting ready the Affected person
1. Clarify the process to the affected person and procure their consent.
2. Place the affected person comfortably in a seated or reclining place.
3. Clear the entry port with an alcohol swab and permit it to dry.Connecting the Syringe
1. Connect a 10-mL syringe to the entry port utilizing a luer lock or adapter.
2. Open the clamp on the syringe and gently aspirate to take away any residual blood.Drawing the Blood
1. Maintain the syringe regular and pull again on the plunger to attract the specified quantity of blood.
2. As soon as the blood is drawn, shut the clamp on the syringe and take away it from the entry port.
3. Invert the syringe and gently faucet on the barrel to take away any air bubbles.Advice Purpose Use a 10-mL syringe or bigger To keep away from creating extreme stress within the PICC line Aspirate gently To forestall damaging the blood cells Invert the syringe after drawing blood To take away air bubbles that would intrude with take a look at outcomes Making use of Tourniquet and Cleansing Insertion Web site
Earlier than drawing blood from a PICC line, it’s essential to arrange the insertion website and apply a tourniquet. Here is an in depth information to make sure correct preparation:
Making use of Tourniquet
1. Choose an appropriate tourniquet, comparable to a blood stress cuff or elastic band. It ought to be huge sufficient to suit comfortably across the affected person’s arm.
2. Place the tourniquet roughly 3-4 inches above the insertion website.
3. Securely wrap the tourniquet across the arm, guaranteeing a comfortable match. Keep away from making use of extreme stress to stop discomfort or harm.
4. Elevate the affected person’s arm to advertise venous filling and make the vein extra seen.Cleansing Insertion Web site
1. Collect obligatory provides, together with alcohol wipes, gauze pads, and gloves.
2. Placed on gloves to keep up sterility.
3. Clear the insertion website with an alcohol wipe in a round movement, ranging from the middle and dealing outward.
4. Permit the alcohol to dry utterly earlier than continuing.
5. Use a gauze pad to softly cleanse the insertion website with sterile water or saline.
6. Pat the world dry with a clear gauze pad.Materials Use Tourniquet Applies stress to blood vessel above insertion website Alcohol wipes Disinfects insertion website Gauze pads Cleanses and dries insertion website Gloves Protects towards contamination Accumulating and Dealing with Blood Samples
Supplies:
- Clear gloves
- Alcohol swabs
- Sterile gauze
- Tourniquet
- Blood assortment tubes
Process:
- Collect supplies: Gather all obligatory supplies earlier than beginning the process.
- Put together the affected person: Clarify the process to the affected person and place them comfortably. Apply a tourniquet to the arm 3-4 inches above the PICC line.
- Cleanse the location: Use alcohol swabs to cleanse the injection space and permit it to dry utterly.
- Entry the PICC line: Connect a sterile extension tubing to the PICC line.
- Draw blood: Gather the blood pattern in keeping with the quantity and sort of tubes required.
- Apply stress and take away the tourniquet: Apply stress to the injection website for a number of minutes to cease bleeding. Take away the tourniquet and permit the blood to circulation again into the vein.
- Gather and deal with the blood: Switch the blood samples into the suitable tubes and label them clearly. Retailer them in keeping with the precise necessities for every take a look at.
Blood Drawing Concerns:
- Quantity: Decide the precise quantity of blood required for every take a look at.
- Components: Guarantee the right blood assortment tubes are used to protect the blood samples.
- Timing: Gather blood on the applicable time in relation to the affected person’s situation or therapy.
- Labeling: Label the blood assortment tubes clearly with the affected person’s title, date, time, and sort of pattern.
- Dealing with: Transport the blood samples to the laboratory promptly and deal with them in keeping with established tips.
Tube Kind Additive Function Pink prime None Serum samples Blue prime Sodium citrate Coagulation research Inexperienced prime Sodium heparin Plasma samples Lavender prime EDTA Full blood depend Disconnecting Syringe and Making use of Stress
7. Disconnect the syringe from the PICC line:
a. Make sure the tourniquet continues to be in place.
b. Grasp the syringe hub with one hand and the needle with the opposite hand.
c. Gently twist the syringe forwards and backwards whereas holding the needle regular.
d. As soon as the needle is unfastened, pull the syringe straight out from the catheter.
8. Apply stress to the puncture website:
a. With the needle eliminated, place a gauze pad over the puncture website.
b. Apply agency and regular stress for 2-3 minutes, or till the bleeding stops.
c. If the bleeding persists, apply a second gauze pad and proceed making use of stress.
9. Get rid of the used syringe and gauze pad correctly:
a. Place the syringe and gauze pad in a sharps container or biohazard waste bag.
b. Get rid of the container or bag in keeping with the power’s coverage.
Step Motion 7a Guarantee tourniquet is in place. 7b Grasp syringe hub and needle. 7c Twist syringe and maintain needle regular. 7d Pull syringe straight from catheter. 8a Place gauze over puncture website. 8b Apply agency stress for 2-3 minutes. 8c Add gauze and proceed stress if bleeding persists. 9a Get rid of syringe and gauze in sharps container. 9b Get rid of container in keeping with coverage. Dressing and Bandaging the Insertion Web site
8. Dressing and Bandaging the Insertion Web site
As soon as the PICC line is inserted, the insertion website should be dressed and bandaged to guard it from an infection and to stop the road from being dislodged. The dressing and bandage ought to be modified each 2 to three days, or extra typically if it turns into dirty or moist. Dressing adjustments ought to be carried out by a healthcare skilled.
Supplies wanted:
Materials Amount Sterile gauze pads 4-6 Sterile tape 1 roll Antiseptic answer 1 bottle Regular saline 1 bottle Steps:
- Collect the supplies.
- Wash your arms completely with cleaning soap and water.
- Clear the insertion website with antiseptic answer.
- Apply sterile gauze pads to the insertion website.
- Safe the gauze pads with sterile tape.
- Label the dressing with the date and time.
- Monitor the insertion website for indicators of an infection.
- Change the dressing each 2 to three days, or extra typically if it turns into dirty or moist.
Documenting and Labeling the Blood Samples
Correct documentation and correct labeling of blood samples are essential to make sure affected person security and the integrity of take a look at outcomes. Comply with these tips to make sure correct documentation and labeling:
1. **Gather the Right Info:** Get hold of the affected person’s full title, medical report quantity, date of beginning, and the date and time of blood draw.
2. **Use the Right Labels:** Use pre-printed labels or fill out labels clearly with the affected person’s title, medical report quantity, and date of beginning.
3. **Label Every Tube Individually:** Every tube containing a blood pattern ought to be labeled with the affected person’s info.
4. **Use Acceptable Components:** If the blood draw requires particular components (e.g., anticoagulant), guarantee the right sort and quantity of additive is added to the tube.
5. **Seal the Tubes Tightly:** All tubes containing blood samples ought to be sealed tightly to stop leakage or contamination.
6. **Place Samples in a Assortment Container:** Place the labeled tubes in an applicable assortment container.
7. **File the Blood Draw within the Affected person’s Chart:** Doc the date, time, and sort of blood draw within the affected person’s medical report.
8. **Submit Samples to the Laboratory:** Submit the labeled samples to the laboratory promptly in keeping with established protocols.
9. **Extra Concerns for PICC Line Blood Attracts:**
a. **Flush the PICC Line:** Earlier than drawing blood, flush the PICC line with 5-10 mL of regular saline.
b. **Discard the First 5 mL of Blood:** The primary 5 mL of blood drawn could include fluid from the PICC line, so discard it to keep away from contamination.
c. **Gather Blood in a Vacuum Tube:** Use a vacuum tube to gather blood from the PICC line to make sure sufficient circulation and stop hemolysis.
d. **Label Vacuum Tubes Clearly:** Clearly label the vacuum tubes with the affected person’s title, medical report quantity, date and time of blood draw, and the kind of blood draw.
Troubleshooting Frequent Points
In case you encounter difficulties whereas drawing blood from a PICC line, observe these troubleshooting ideas:
**1. No Blood Return:**
- Make sure the PICC line is correctly flushed with saline.
- Examine if the tourniquet is positioned accurately and never too tight.
- Strive utilizing a unique needle measurement or model.
**2. Gradual Blood Return:**
- Enhance the flushing price or think about using a heparin lock flush.
- Apply a heat compress to the insertion website.
- Keep away from bending or kinking the PICC line throughout blood draw.
**3. Clot Formation:**
- Aspirate slowly and gently.
- Think about using a clotting time analyzer to make sure the affected person’s blood will not be clotting prematurely.
- Flush the PICC line extra steadily with saline.
**4. Hemolysis:**
- Use a smaller needle measurement and a slower aspiration price.
- Keep away from shaking or agitating the blood pattern.
- Centrifuge the blood pattern gently.
**5. Air Embolism:**
- Examine if the PICC line is correctly primed.
- Elevate the affected person’s arm to advertise air evacuation.
- Contact a doctor instantly if an air embolism is suspected.
**6. An infection:**
- Examine the insertion website for redness, swelling, or drainage.
- Change the dressing commonly and observe correct an infection management measures.
- Contact a doctor if indicators of an infection are current.
Problem Troubleshooting Ideas No Blood Return Flush PICC line, verify tourniquet, strive completely different needle Gradual Blood Return Enhance flushing price, apply heat compress, keep away from bending PICC line Clot Formation Aspirate slowly, use clotting time analyzer, flush PICC line extra steadily Hemolysis Use smaller needle, slower aspiration price, keep away from shaking pattern Air Embolism Prime PICC line correctly, elevate affected person’s arm, contact doctor An infection Examine insertion website, change dressing, contact doctor The right way to Draw Blood From a PICC Line
A PICC line is a peripherally inserted central catheter that’s positioned in a big vein within the arm. It’s used to attract blood for testing, administer drugs, and supply fluids. To attract blood from a PICC line, you have to the next provides:
- Alcohol swabs
- Gauze padsSyringe
- Tourniquet
- Butterfly needle
- Blood assortment tube
After you have gathered your provides, observe these steps to attract blood from a PICC line:
1. Wash your arms and placed on gloves.
2. Apply a tourniquet to the arm about 4 inches above the PICC line insertion website.
3. Clear the PICC line insertion website with an alcohol swab.
4. Insert the butterfly needle into the PICC line.
5. Connect the syringe to the butterfly needle and draw the blood into the syringe.
6. Take away the syringe from the butterfly needle and fix the blood assortment tube to the syringe.
7. Invert the blood assortment tube and gently combine the blood with the anticoagulant.
8. Take away the tourniquet and apply stress to the insertion website with a gauze pad.Folks Additionally Ask About The right way to Draw Blood From a PICC Line
What’s a PICC line?
A PICC line is a peripherally inserted central catheter that’s positioned in a big vein within the arm. It’s used to attract blood for testing, administer drugs, and supply fluids.
How lengthy can a PICC line keep in?
A PICC line can keep in for as much as 12 months.
Can I draw blood from a PICC line at residence?
No, you shouldn’t draw blood from a PICC line at residence. This could solely be executed by a educated healthcare skilled.
