If we need to give meds and have no other access it will be into the lumen with the TPN. Our transplant patients often have tacrolimus (which doesn't play well with others) in one lumen and ATGAM (which MUST run alone) in another. I'm not sure why your HIV patients would need a second site for antibiotics unless they had something else running into one of the lumens that couldn't be interrupted. The furosemide would be stopped and flushed for antibiotic or other incompatible med infusions. The only access we may have in a child is a triple lumen CVC through which we could be running TPN and lipids in one lumen, epinephrine, norepinephrine, milrinone, morphine, and midazolam in another and furosemide in the third. I've worked in PICU for more than 12 years and we run incompatible solutions into our lines all the time, as long as they're in different lumens. That essentially means that the line isn't a single line, it's three lines. The idea was to show how the lines are designed with the lumens completely separate from each other. Those pictures are cross-sections of two different types of multi lumen CVCs. It would seem somewhat counterproductive if the contents of the two lumens mixed inside the catheter in those circumstances now wouldn't it? Catheters used for hemodialysis and continuous renal replacement therapy have two large lumens that allow the aspiration of blood from one lumen and the infusion of blood into the other. They infuse into large vessels with rapid, high-volume blood flow that does not allow physical mixing of incompatible meds. Multi lumen central venous lines have completely separate lumens that exit the line at different spots along the side of the line with the largest lumen usually opening at the proximal tip.
Something about a "huge catheter" in their neck is intimidating to some patients. You only have two possible femoral sites the it can go to the subclavian which usually freaks out patients. All the lumens go to the same central line so they would be mixing and if they are not compatible you just destroyed a perfectly good central line and your patient may be forced to endure another central line placement at a different site. Way to go for finding out the way to use these catheters.If two medications are not "Y compatible" then you cannot run them at the same time into two different ports in the same central line access site. I certainly would not infuse two first doses of such medications if I had the option. There are many drips that you can not just stop. Some of these books can be quite costly.the INS one is about 100 bucks or so.Īlthough it is a good idea to infuse first doses without other medications that have a propensity to cause a hypersensitivity reaction, this is not always feasible. Just PM me and let me know where I can send it. I can also give you a reference if you like and would even photocopy any section from my multiple infusion therapy books, I just bought a ton of new books to study for my recertification of my CRNI.
#Double lumen picc line tpn and antibiotics free
Please feel free to bring them a copy of this discussion.
Do you know what type of CVC or PICC brand you are using and I can further explain anything special about that particular catheter. They will have a cross section view that clearly explains and shows you how each lumen is separate. If you go to any manufactures web site you will find pictures of their available catheters. Va jenny, the nurses you are trying to educate simply do not understand catheter design.
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