How to Tell the Difference Between Open and Closed-Ended PICCs

The important things first. What is a PICC line?

PICC stands for Peripherally Inserted Central Catheter. They are used for direct access to larger blood vessels in the body. Patients use PICC lines when receiving large amounts of IV drugs, volatile drugs (such as high-performance antibiotics), or long-term medications.

PICC lines are unique because they are inserted peripherally, meaning from the arm. The catheter extends through the vessels in the arm to the heart.

There is a wealth of information about PICC lineage maintenance on the internet, but it is difficult to decipher whether a PICC lineage is open or closed. To distinguish between the two, just by looking:

Look for the clamp.

  • If it is an open PICC then there is a clamp.

  • If it is a closed PICC, there is no clamp.

Why? Here is the explanation:

Imagine the PICC line in the body. It’s a thin, rubbery catheter. The most important part is the end of it.

An open-ended PICC has an opening at the end through which fluids and medication can be pushed in and blood drawn. You can imagine it looking like a garden hose: tubular, with an open end.

A closed-end PICC instead has a thin slit-like valve on the side that performs the same function. The end is not open. In fact, it looks like a cone or it can be smooth like the front end of an airplane.

What is the difference?

The open-ended PICC creates turbulence when blood flows past it.

Because the tip is not smooth, blood does not flow past it very easily. The problem is that turbulence causes blood to clot in the vessel. A stuck PICC line is the worst type of PICC line. To prevent clotting, these types of PICC lines must be heparinized. (This means a saline flush followed by a heparin flush after application. Heparin, an anticoagulant, prevents blood from clotting.)

On the other hand, the closed PICC’s smooth, more “aerodynamic” tip facilitates blood flow and therefore does not require a heparin flush.

Why is there a clamp?

The closed end PICC is valved and therefore does not require a clamp. A valve lets fluid go one way but not the other. The “slit” on the side of the catheter is specifically made to allow fluid to drain out of the catheter but not allow blood to flow into it.

An open PICC, on the other hand, has no valve. Nothing prevents blood from entering the catheter. To prevent this, a clamp interrupts the movement of liquid (similar to how clamping a straw traps the liquid it contains. Nothing comes in, nothing comes out.)

What is a Groshong PICC?

You may have heard about it. It’s very easy. Groshong is a trade name for a closed PICC. A Groshong is a closed PICC.

Once again:

Just look for the clamp!

Happy documenting, nurses!

#Difference #Open #ClosedEnded #PICCs

Thanks to Kevin K Pan

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