Equipment 8-684 - PICC and Central Line Access Kit

CMH EMS & MIH Protocols

Scope of Practice:

Registered Nurse
Paramedic

Indications:

Express request by the patient to utilize established access instead of starting an IV.
Any patient who needs IV access, two attempts at IV access have failed, IO contraindicated or conscious patient, and at least one of the following:

ALOC or GCS less than 8,
Hemodynamic instability,
Extreme respiratory compromise, OR
Full Arrest.

Contraindications:

Inability to obtain/maintain sterile field.

Precautions:

Sterile technique must be utilized.

Procedure:

Cleanse the needless infusion cap. May use any catheter present.
Aseptically attach flush.
Open clamp on catheter lumen.
Aspirate fluid from catheter slowly until blood return. If unable to aspirate blood, catheter is clotted and will need to be declotted in a hospital setting.
Flush with NS/LR. Use at least a 10 ml syringe using a push-pause method. Remove flush while maintain pressure on syringe plunger.
Attach appropriate IV fluids.

Citations:

Protocol 9-010 - References
Citizens Memorial Hospital, 2013.

Change Log:

Date	Link to previous version	Description of change
04/05/18	pdf	Per CMH Vascular Access Team, added comment to use at least a 10 ml syringe and use a push-pull method.
11/27/19	pdf	Added comment that PICC could be accessed prior to IV attempts at the request of the patient.
07/04/20		Renumbered the section to allow for future additions.
08/07/20	pdf	Added content (without substantive modification) from old Section 8-295 - PICCCentral Line Access Kit.
06/15/21	pdf	Moved to emsprotocols.online
03/17/23		Changed link to NS.
03/19/23		Changed link for LR.

Return to Protocols Table of Contents.

CMH Pre-Hospital Services Mission: "Provide safe, exceptional, and compassionate care to our communities with an emphasis on highly trained and empowered staff."

CMH Mobile Integrated Healthcare Mission: "Provide exceptional, compassionate, and patient-centered care by a mobile collaborative team to improve patient experience, improve quality outcomes, and reduce healthcare costs."

Polk, Hickory, Cedar, & St Clair County EMS Protocols is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Change Log:

Date	Link to previous version	Description of change
04/05/18	pdf	Per CMH Vascular Access Team, added comment to use at least a 10 ml syringe and use a push-pull method.
11/27/19	pdf	Added comment that PICC could be accessed prior to IV attempts at the request of the patient.
07/04/20		Renumbered the section to allow for future additions.
08/07/20	pdf	Added content (without substantive modification) from old Section 8-295 - PICCCentral Line Access Kit.
06/15/21	pdf	Moved to emsprotocols.online
03/17/23		Changed link to NS.
03/19/23		Changed link for LR.

Return to Protocols Table of Contents.

CMH Pre-Hospital Services Mission: "Provide safe, exceptional, and compassionate care to our communities with an emphasis on highly trained and empowered staff."

Polk, Hickory, Cedar, & St Clair County EMS Protocols is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.