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What if a PICC line doesn’t have a cap?

H is home from the hospital with a PICC line and I am infusing Meropenem every 8 hours for 6 weeks.

I was told by the company that provides the "medicine balls" of meropenem, that there is a national/worldwide? sortage on caps for the end of the line. This has horrified me. Until tonight, I have managed to get as many caps as I could possibly find, including some donations from our home health nurse. But as I knew would happen, tonight I am faced with no end cap after I finish with the antibiotic, flush with saline, and them with heparin.

Does this horrify you medical people as much as it is horrifying me?

The nurses that were helping with my husband‘s discharge from the hospital heard me speaking with the company that provides the medication. They said that, yes, there was a widespread shortage, and that it would be OK. A member of the IV team that placed the PICC line said that there was some sort of mechanism inside the end of the line that the saline and heparin engage and it withdraws so that the fluid can go in. And that when I remove the saline and heparin push, that part of the end of the PICC line "reseeds" into the end of the PICC line and prevents contamination.

(Sorry that explanation sucks, but I don’t speak "medical").

The home health nurse I am really trust has told me that it would be fine. I have asked her if I should rubber band an alcohol prep pad over the end of the line. Or maybe I could soak the used cap I took off, in some alcohol and then reuse it? Almost anything seems better than just leaving the cap off.

What do you all think? If I simply cannot get a hold of a cap each time every day, is there some way I should "rig" the end of that line so that it could be protected?

What about if I just leave the heparin push connected to the PICC line and don’t remove it?

Would that protect the line from infection?

Or, because that pushes through that thing that seeds itself at the end of the line and protects the line, would that hold open a channel for the infection to enter?

In the old days, we reused caps for a few days. So I would recommend wiping the cap really well w/ an alcohol prep, and putting back on, or leaving the flush attached if he isn't moving around a bunch. The last thing you want to do is have it get caught on something and yank it out.
I would also double/triple wipe that end if you have left it w/o a cap before the next dose.

Thx.

I didn’t hear from the home health nurse that night, until noon the next day. And by that time I had infused 3 times. Because she had said not to reuse the cap, and not to leave on the heparin flush, I just left it uncovered.

I did get a freshly laundered white hospital sheet, fold it, and wrap it loosely around his arm, covering the end of the picc line. Just to protect it from the puppy if nothing else. Just in case she got near it.

It’s so very hard to be responsible for my H when I feel I sometimes end up doing things I’m not sure about.

I’ve done something to my knee and I’m probably looking at at least meniscus surgery, if not replacement.

I guess it’s time to put a plan in place for when I’m simply unable (physically) to take care of him. Temporarily and permanently.

When it rains, it pours. 😏