regarding technique....when we are
drawing blood from a TPN line, even if it is from the unused lumen, we shut the
TPN off for a minimum of 2 minutes. After first shutting TPN off, we flush
thoroughly with 10ml 0.9%NaCl, then leave it off for the 2 minutes. We
then draw a waste, the labs, then flush again with another 10ml, then restart
the TPN.
That has worked for us, and is also
how it is supposed to be done at the hospital. Our labs come back in
expected ranges.
Good luck!
ann
Ann Williams RN CRNI
Infusion Specialist
Deaconess Home Services
600 Mary St.
Evansville, IN 47747
812-450-3828
812-450-4665
FAX
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of G.G. Northington
Sent: Tuesday, August 15, 2006 10:26 AM
To: [EMAIL PROTECTED]
Subject: PICC with TPN and lab samples
I have a patient
that had a dual lumen power PICC inserted on 8-3-06. TPN was
initiated through one lumen and the other lumen utilized for maintaince fluids
(D51/2 NS) and lab draws. The last 3-4 days (not consecutive) the
patient's glucose has been elevated on the lab results, but a finger stick has
had much lower results. The patient's WBC's are elevated, but not a new
finding. The physician is concerned with infection. My first thought
was that the nurses are pulling the TPN with their lab draw.--It is common
practice on this floor to draw the lab work while the TPN is infusing, so I
suggested to stop it briefly before the next lab draw to see if there is a
difference in the results.
With the background
given, what are your thoughts on possible infection vs. the nurses "technique"
on obtaining the sample?
Thanks,
G.G.
G.G. Northington,RN,BSN
PICC Nurse
Jackson Hospital &
Clinic,Inc.
Montgomery,AL 36016
334-293-6858
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