Drawing blood from a peripherally inserted central catheter (PICC) line is a necessary nursing talent. PICC strains are lengthy, skinny tubes which might 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 medicines, fluids, and blood merchandise, and to attract blood for laboratory testing. Drawing blood from a PICC line might be accomplished safely and successfully by following the right steps.
Earlier than drawing blood from a PICC line, the nurse should first confirm the affected person’s id and the order for the blood draw. The nurse ought to then collect the mandatory provides, together with a tourniquet, gauze pads, alcohol wipes, a syringe, and a blood assortment tube. The nurse also needs to put on gloves and a robe to forestall 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 web site 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 web site 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 mandatory gear and supplies. To make sure a easy and profitable process, it’s important to organize all of the required objects meticulously.
### Important Gadgets
Syringes: Choose a 10-mL syringe for gathering 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 usually used to entry the PICC line.
Alcohol swabs: Alcohol swabs are used to scrub the injection web site 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 certain 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 forestall clots and preserve the patency of the PICC line.
Private protecting gear (PPE): Gloves and a masks are important for an infection management throughout the blood draw process.
| Merchandise | Amount | Goal |
|---|---|---|
| 10-mL syringe | 1 | For gathering 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 web site 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 gathering blood pattern |
| Saline flush | 1 vial | For clearing PICC line |
| Gloves | 1 pair | For an infection management |
| Masks | 1 | For an infection management |
Establishing Appropriate Affected person Identification
Correct affected person identification is essential to make sure the right affected person receives the suitable care. To ascertain right affected person identification, comply with these steps:
**1. Test the Affected person’s Identification Band:**
- Confirm that the affected person’s title, date of delivery, and medical file 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 delivery.
- If the affected person is unable to speak verbally, consult 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 id utilizing further identifiers equivalent to a photograph ID or fingerprints.
**3. Examine Bodily Traits:**
- Word the affected person’s basic look, together with top, weight, and facial options.
- Examine 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 mandatory.
**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 medicines or throughout high-risk procedures.
Adhering to those steps helps guarantee correct affected person identification and reduces the danger of errors that might 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.Suggestion Motive Use a 10-mL syringe or bigger To keep away from creating extreme stress within the PICC line Aspirate gently To stop damaging the blood cells Invert the syringe after drawing blood To take away air bubbles that might intrude with check outcomes Making use of Tourniquet and Cleansing Insertion Web site
Earlier than drawing blood from a PICC line, it’s essential to organize the insertion web site and apply a tourniquet. This is an in depth information to make sure correct preparation:
Making use of Tourniquet
1. Choose an appropriate tourniquet, equivalent to a blood stress cuff or elastic band. It ought to be broad sufficient to suit comfortably across the affected person’s arm.
2. Place the tourniquet roughly 3-4 inches above the insertion web site.
3. Securely wrap the tourniquet across the arm, guaranteeing a cosy match. Keep away from making use of extreme stress to forestall 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 mandatory provides, together with alcohol wipes, gauze pads, and gloves.
2. Placed on gloves to take care of sterility.
3. Clear the insertion web site with an alcohol wipe in a round movement, ranging from the middle and dealing outward.
4. Permit the alcohol to dry fully earlier than continuing.
5. Use a gauze pad to softly cleanse the insertion web site with sterile water or saline.
6. Pat the realm dry with a clear gauze pad.Materials Use Tourniquet Applies stress to blood vessel above insertion web site Alcohol wipes Disinfects insertion web site Gauze pads Cleanses and dries insertion web site Gloves Protects in opposition to contamination Gathering and Dealing with Blood Samples
Supplies:
- Clear gloves
- Alcohol swabs
- Sterile gauze
- Tourniquet
- Blood assortment tubes
Process:
- Collect supplies: Gather all mandatory 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 fully.
- Entry the PICC line: Connect a sterile extension tubing to the PICC line.
- Draw blood: Gather the blood pattern in response to the quantity and sort of tubes required.
- Apply stress and take away the tourniquet: Apply stress to the injection web site for a number of minutes to cease bleeding. Take away the tourniquet and permit the blood to stream 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 response to the particular necessities for every check.
Blood Drawing Issues:
- Quantity: Decide the precise quantity of blood required for every check.
- 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 response to established tips.
Tube Sort Additive Goal Pink prime None Serum samples Blue prime Sodium citrate Coagulation research Inexperienced prime Sodium heparin Plasma samples Lavender prime EDTA Full blood rely 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 backwards and forwards whereas holding the needle regular.
d. As soon as the needle is free, pull the syringe straight out from the catheter.
8. Apply stress to the puncture web site:
a. With the needle eliminated, place a gauze pad over the puncture web site.
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 response to the ability’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 web site. 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 response to 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 web site have to be dressed and bandaged to guard it from an infection and to forestall 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 palms completely with cleaning soap and water.
- Clear the insertion web site with antiseptic answer.
- Apply sterile gauze pads to the insertion web site.
- Safe the gauze pads with sterile tape.
- Label the dressing with the date and time.
- Monitor the insertion web site 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 check outcomes. Observe these tips to make sure correct documentation and labeling:
1. **Gather the Appropriate Info:** Get hold of the affected person’s full title, medical file quantity, date of delivery, and the date and time of blood draw.
2. **Use the Appropriate Labels:** Use pre-printed labels or fill out labels clearly with the affected person’s title, medical file quantity, and date of delivery.
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 forestall leakage or contamination.
6. **Place Samples in a Assortment Container:** Place the labeled tubes in an applicable assortment container.
7. **Report the Blood Draw within the Affected person’s Chart:** Doc the date, time, and sort of blood draw within the affected person’s medical file.
8. **Submit Samples to the Laboratory:** Submit the labeled samples to the laboratory promptly in response to established protocols.
9. **Extra Issues 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 stream and stop hemolysis.
d. **Label Vacuum Tubes Clearly:** Clearly label the vacuum tubes with the affected person’s title, medical file quantity, date and time of blood draw, and the kind of blood draw.
Troubleshooting Widespread Points
Should you encounter difficulties whereas drawing blood from a PICC line, comply with these troubleshooting ideas:
**1. No Blood Return:**
- Make sure the PICC line is correctly flushed with saline.
- Test if the tourniquet is positioned accurately and never too tight.
- Strive utilizing a distinct needle dimension or model.
**2. Sluggish Blood Return:**
- Enhance the flushing price or think about using a heparin lock flush.
- Apply a heat compress to the insertion web site.
- 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 ceaselessly with saline.
**4. Hemolysis:**
- Use a smaller needle dimension and a slower aspiration price.
- Keep away from shaking or agitating the blood pattern.
- Centrifuge the blood pattern gently.
**5. Air Embolism:**
- Test 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 web site for redness, swelling, or drainage.
- Change the dressing often and comply with correct an infection management measures.
- Contact a doctor if indicators of an infection are current.
Situation Troubleshooting Ideas No Blood Return Flush PICC line, test tourniquet, strive totally different needle Sluggish 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 ceaselessly 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 web site, 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 medicines, and supply fluids. To attract blood from a PICC line, you’ll need the next provides:
- Alcohol swabs
- Gauze padsSyringe
- Tourniquet
- Butterfly needle
- Blood assortment tube
After you have gathered your provides, comply with these steps to attract blood from a PICC line:
1. Wash your palms and placed on gloves.
2. Apply a tourniquet to the arm about 4 inches above the PICC line insertion web site.
3. Clear the PICC line insertion web site 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 connect 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 web site with a gauze pad.Individuals 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 medicines, 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 accomplished by a educated healthcare skilled.
