I need to contact Kathy Kokotis. There are some major educational needs up in her area. I had to contact a doc up in Kathy's area regarding a double lumen PICC with one lumen completely occluded and the other is very sluggish. He refused to allow us to cathflo this PICC because he "never heard of such a thing" and I was not able to convince him of the risks involved in leaving it occluded. Bottom line is, how many other physicians out there are oblivious to proper central line care and maintainence? And, is this why we in home care get so many central lines that are partially occluded? I bet 99.9% of our patients who were hospitalized come to us with no blood return and tell us the nurses in the hospital never got a blood return or worse stories. Valorie Dunn,
Your area isn't the only one that needs education. Got a phone call this morning from a hospital case manager that was ready to d/c a pt home on 6 weeks of IV abts. Pt had 2 ports in-one on each side. The first port was non-functioning and according to the pt 2 attempts had been made to remove the port and it was reported as being "stuck" in her heart-chest x-ray does confirm tip placement of this port in the right atrium. So another port was placed on the other side-this port became "non-functioning" over the weekend and rather than attempting to de-clott a decision was made to place a PICC which was done early this morning. On top of this pt. now having 3 central lines she also has a VP shunt and spinal rods!! What a nightmare waiting to happen!! I strongly suggested to the case manager that something had to be removed. Not only due to the increased risk of infection of all three lines in place but also the increased risk of thrombus on the side that two of the lines were in. She was going to relay info back to docs. What a mess!!