Gwen,
 
We us use PICCs for chemo but we alway use a pump.  We are a hospital based 
outpatient setting and try to comply with JCAHO standards of no free flowing 
IV's.  I have heard from other nurses that they have problems free flowing 
fluids via a PICC.   We flush all our PICC's with saline only and have have 
only rare incidents of occlusions which when addressed early clear with 
installation of Cath Flo Activase.  Prior to using
Bard Groshong PICC we used the BD per q cath and never had problems with these 
PICC clotting off either.
 
Margaret
 
Margaret M Nicastro, CRNI, OCN
Coorordinator IV Therapy/Oncology
Gettysburg Hospital
147 Gettys Street
Gettysburg, PA 17325
Phone:  717-337-4312 option 2
Fax:  717-337-4485
 
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________________________________

From: [EMAIL PROTECTED] on behalf of Gwen Irwin
Sent: Tue 5/9/2006 8:33 PM
To: [EMAIL PROTECTED]
Subject: Chemo given via PICCs


I have recently been asked about giving chemo through a "free-flowing" IV 
related to PICCs.  We have one of the hospitals with an oncology floor that 
believe, since we have changed to saline only flushing, they can't give chemo 
via free-flowing IV fluids via a PICC.  They report that this is the case after 
the PICC has been in for a few weeks.  They also report more occlusions that 
occur with PICCs.  I am checking the actual number (of occlusions) for 
comparison before and after saline only flushing.  I have offered inservices 
related to proper flushing (that has been effective on other floors that had a 
rapid decline in their occlusions, after inservicing).
 
Has this chemo issue that they report been anyone else's experience?  I am 
debating how to answer their question and their request for heparin to be added 
to flushing policy for their population of patients.
 
Thanks for any help.
 
Gwen Irwin
Austin, Texas

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