To clamp or not to clamp?

Hi Nancy,

We have been getting residents admitted from the hospital with their PICC lines unclamped.  Is there ever a time a PICC line should be unclamped unless you are running something into it, flushing it, or withdrawing blood?  I thought clamping it was necessary to lock it at the end of the flush.  Is there a certain brand of PICC that should not be kept clamped when not in use?  Your advice is much appreciated!

R.D. 5/7/19

Clamping is a confusing issue for many people and even when clear on the why and when it is often done inconsistently. I addressed this clamping point in one of my papers, lead author Hull 2017 researching needleless connectors. That is really the why of clamping, to prevent reflux when NC don’t. 

Here’s where the confusion comes in, depending on the NC you may clamp before disconnection (negative displacement NC), after disconnection (positive displacement), or not at all when an anti reflux valve is present (only two NC have that Nexus TKO and ICU Medical Neutron). 

You are absolutely correct that most NC/PICCs should be clamped because there is no flow control valve. The easy answer to your question is YES, when in doubt, clamp. Only the two anti reflux NC don’t need clamping and even if they are clamped it is fine. 

Happy to help, please email me anytime!

Warm wishes, Nancy Moureau RN, PhD, CRNI, CPUI, VA-BC

Link to Hull, Moureau 2011 reference

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