Central Venous Access Devices

  Port-a-cath Broviac/Hickman Central Line PICC Lines
Flush Every 28 days when not in use.

Flush 10 cc NS, then 30 u Heparin		 To be flushed every 3 days when not being used and after each use.  Use 10cc NS followed by 30u Heparin Every 8 hours and after each use.

3-10 cc NS		 Every 12 hours with 5 cc NS in a 20cc syringe or bigger.
Needle-Free injection site adapter change Not Applicable Every 3 days and after each blood draw Every 3 days and after each bglood draw Every 3 days and after each blood draw.
Dressing Change Every 7 days and PRN.  Use CVP dressing change kit. 
Gauze dressing change after 48 hrs or sooner.		 Every 7 days using CVP dressing kit.  Avoid touching catheter with alcohol.  Gauze dressing. change every 48 hrs or sooner. Every 7 days using CVP dressing kit and occlusive dressing.
Gauze dressing change every 48 hrs or sooner.		 Every 7 days using CVP kit and occlusive dressing.  Gauze dressing
Blood Draw:
**Turn off all infusing IV fluids prior to drawing		 Discard 3 cc1  Draw sample, then flush.

**Never withdraw blood with syringe smaller than 10 cc.		 Discard 3cc1, draw sample, flush with 10 cc NS.

**Never withdraw blood with syringe smaller than 10 cc.		 Discard 3 cc1  Draw sample, then flush.

**Never withdraw blood with syringe smaller than 10 cc.		 Only to be done in emergent situations.
*Flush vigorously with 20 cc NS after drawing blood.
**Never withdraw blood with syringe smaller than 10 cc.
Important Information Encourage access in OR after placement.  May be accessed 24 hours after surgery with surgeons approval.
**Non coring needle should be changed every 7 days.		 Cath breakage: clamp, immediately call MD, obtain temporary repair kit from exchange cart. 

Teaching required prior to D/C.		 Lumen sizes:  18g White, 18g Blue, 16g Brown,
Chest X-ray required for placement prior to use. 
Dedicate one lumen for TPN/PPN		 Use 20cc or larger syringe.
X-ray required for placement prior to use. 
Can only be inserted by certified personnel.

1The first discarded blood may be used for blood culture and can be used for type & cross.

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