I posted 2 weeks ago about our facility updating its PICC line flushing protocol.
It is being changed to flushing non valved piccs with 5mls of 10 units per ml of heparin.
We started doing this with our current picc patient and he is clotting all the time. He has also clotted when a nurse used 5mls of 100u/ml heparin yesterday.
He gets every 24hr antibiotics I am concerned about the using the Cathflo so often on him. Any thoughts
Catheter lumen occlusion involves much, much more than just the locking solution being used. You did not mention the primary and secondary medical diagnoes of the patient. Does this include any hypercoagulable diseases? Where is the catheter tip? Are you certain that it remains in the original location or has it moved to a smaller vein? What type of needleless connector is being used? What sequence of flushing and clamping? Are you certain that this is actually a thromboitc problem or could this be some other type of occlusion? If tPA is resolving the patency problem, i would assume that it is thrombotic rather than a drug precipitte. I would begin to troubleshoot this by first getting a chest xray to see exactly where the catheter tip is located. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861