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VASCULAR ACCESS via

CENTRAL CATHETERS

CLINICAL INDICATIONS:
• In the presence of a life threatening condition, with clear indications for immediate use of
medication or fluid bolus. (Not for prophylactic IV access.)
CONTRAINDICATIONS:
• Suspected infection at skin site.
PROCEDURE:
• Determine the type of catheter present: PICC, Broviac, Hickman, Groshong Mediport,
etc.
Procedure for peripherally inserted Central Catheter (Cook, Neo-PICC, etc.)
and Tunneled Catheter (Broviac, Hickman, Groshong, etc.):

• Prepare equipment:
o 2-3 10mL prefilled syringes of 0.9% NaCl
o Sterile gloves (if available)
• If more than one lumen is available (PICCs, Hickmans and Broviacs can have one, two,
or three lumens), select the largest lumen available.
• Vigorously cleanse the cap of the lumen with chlorhexidine or 70% alcohol prep pad,
allow to dry.
• Unclamp the selected catheter lumen and using a prefilled 10ml syringe:
o Vigorously flush the catheter using a pulsating technique and maintaining
pressure at the end of the flush to prevent reflux of fluid or blood
o If catheter does not flush easily (note that a PICC line will generally flush more
slowly and with greater resistance than a typical intravenous catheter), re-clamp
the selected lumen and attempt to use another lumen (if present)
o If unable to flush any of the lumens, the catheter is unable to be used
• Attach primed IV administration set and observe for free flow of IV fluid.
o Utilizing an IV pump, set the flow rate based on the patient condition and IAW
SMOG
Document procedure, results, and vital signs.

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