Our policy is to stop the infusion for 2-5 minutes flush well (10 -20 ml), do a discard and then draw the specimen, flush with NSS and restrart the TPN
Ann Marie Parry RN Clinical Coordinator VITALine Home Infusion Pharmacy Danville, PA [EMAIL PROTECTED] 1-800-245-8767 >>> "Ann Williams" <[EMAIL PROTECTED]> 08/15/06 12:44 PM >>> 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 [EMAIL PROTECTED] -------------------------------------------------------------------------------------------------------------------- This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error please notify the originator of the message. Any views expressed in this message are those of the individual sender, except where the sender specifies and with authority, states them to be the views of Deaconess Health System. IMPORTANT WARNING: The information in this message (and the documents attached to it, if any) is confidential and may be legally privileged. It is intended solely for the addressee. Access to this message by anyone else is unauthorized. If you are not the intended recipient, any disclosure, copying, distribution or any action taken, or omitted to be taken, in reliance on it is prohibited and may be unlawful. If you have received this message in error, please delete all electronic copies of this message (and the documents attached to it, if any), destroy any hard copies you may have created and notify me immediately by replying to this email. Thank you.
