Page 216 - 2026 SMOG

VASCULAR ACCESS VIA CENTRAL CATHETERS
• Aspirate 3–5mL of blood with the syringe
˚ If unable to aspirate blood, reclamp the catheter and do not attempt further use
Asking the patient to cough may facilitate access to the port
˚
• Flush the catheter with 3–5mL 0.9% NaCl using a prefilled 10mL syringe
˚ If the catheter does not flush easily, do not attempt further use
• Attach the IV administration set and observe for the free flow of IV fluid
• Cover the needle and insertion site with the sterile occlusive dressing
**Document procedure, results, and vital signs.**
CATHETER SIZE MAX FLOW RATE
PICC Less than 2.0 fr 125mL/hr
PICC Greater than 2.0 fr 250mL/hr
Groshong PICC 3 fr 240mL/hr
Groshong PICC NXT 4 fr 540mL/hr
Groshong PICC NXT 5 fr 200mL/hr
Hickman/Broviac 8–9.5 fr 3000mL/hr
Pearls
• Do not exceed recommended flow rates.
• Avoid taking a blood pressure reading in the same arm as the PICC.
• Only non-coring, right-angle needles specific for implanted ports are to be used for vascular
access devices that are implanted in the patient. These are generally not carried by MEDEVAC
units but may be provided by the patient.
• Priming the tubing of the non-coring needle is essential to prevent air embolism.
• There are many peripherally inserted, tunneled, and/or implanted port options. Providers should
do their best to discern what option the patient has. The patient may be carrying a reference/
wallet card about their device.
• PICC lines will not tolerate rapid infusions or infusions under pressure.
**Document procedure, results, and vital signs.**

208 • PROCEDURES