PICC line blood draw

What's the proper way to draw blood from a picc line? The other day I flushed with 10 cc's of NS, then wasted 10, then drew blood. But the lab called to say that the results looked wrong (extremely low hemoglobin level) and that the blood probably had saline in it. Another nurse told me that I'm supposed to waste more than I flush and that I did it wrong. Is that correct?
1.flush w/ 10ml NS2. Withdraw 20 ml and waste3. The 3rd syringe should be used4. Flush w/ 10 mls NS5. Change the capsThat's how I learned it...Sent from my iPhone using allnurses.com

I feel like an idiot, but what caps? I've never heard of anything like that.And I remember learning to waste 6, so I thought 10 would be plenty =/

Quote from OCRN31.flush w/ 10ml NS2. Withdraw 20 ml and waste3. The 3rd syringe should be used4. Flush w/ 10 mls NS5. Change the capsThat's how I learned it...Sent from my iPhone using allnurses.com

Quote from cardiacfreakThe cap is the lock on the end of the line.

Flush w/10 mL NS.Draw and waste 10 mL NS.Draw blood needed for labs.Flush with 20 mL of NS.At my facility, caps are only changed if they were removed for drawing blood cultures.

Quote from greyL Hmmm ... I think that maybe we don't have those.

Quote from boogalinaFlush w/10 mL NS. Draw and waste 10 mL NS. Draw blood needed for labs. Flush with 20 mL of NS. At my facility, caps are only changed if they were removed for drawing blood cultures.

Quote from greyLWhat's the proper way to draw blood from a picc line? The other day I flushed with 10 cc's of NS, then wasted 10, then drew blood. But the lab called to say that the results looked wrong (extremely low hemoglobin level) and that the blood probably had saline in it. Another nurse told me that I'm supposed to waste more than I flush and that I did it wrong. Is that correct?

Quote from greyLWhat's the proper way to draw blood from a picc line? The other day I flushed with 10 cc's of NS, then wasted 10, then drew blood. But the lab called to say that the results looked wrong (extremely low hemoglobin level) and that the blood probably had saline in it. Another nurse told me that I'm supposed to waste more than I flush and that I did it wrong. Is that correct?

I'm disturbed how common wasting 10ml is. Keep in mind blood draws and wastes are the main cause of iatrogenic anemia, which is largest cause of blood loss in hospitalized patients.2-3 times the lumen volume is sufficient, additional waste provides no additional benefit. A power lumen on a PICC has the largest volume and is 1.7 ml. Non-power lumens are less than 1 ml.

It is good practice to change the caps on the picc anytime you draw blood or administer blood as well as with every dressing change. I am sure your facility has a policy for drawing blood from a picc. I like to refer to the policy for questions like that because every facility is different and sometimes we just do it the way we know vs the way the hospital wants.

Another flush with 10ml, waste 10ml and flush with 20 ml after the blood draw.