Does anyone know if there is a written standard anywhere regarding length of dwell time for a non-tunneled CVC? At our hospital we usually leave them in for ten to fourteen days max but I can't find anything written about this.
Does anyone know if there is a written standard anywhere regarding length of dwell time for a non-tunneled CVC? At our hospital we usually leave them in for ten to fourteen days max but I can't find anything written about this.
There is no standard, guideline or recommendation about the length of time any catheter can dwell. CDC Guidelines states there is no known optimal dwell time for midline, PICCs, nontunneled, tunneled cuffed or implanted ports. This practice at your hospital is probably based on the opinion of your infection control staff/hospital epidemiologist, or infectious disease physicians. 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
Non tunneled triple lumen CVC's (specifically the Arrow) is a short term device which as per the FDA has a "less than 30 day dwell."
Cheryl Kelley RN BSN, VA-BC
I would encourage you to look at the origin of this category system. It comes from an FDA Guidance document released in 1997 and there have been NO updates to it since then. Long-term is more than 30 days. Short term is less that 30 days. Guidance documents are written for the manufacturer and not for clinical practice. This document does not require clinical data before a manufacturer decides which category their device belongs in. So this is NOT clinical data. For many years, all VADs were categories as less than 30 days, yes even implanted ports and tunneled catheters. So for years, these devices were left in place beyond this 30 days. It is only recently with the marketing of the new midline catheters that healthcare professionals knew anything about this. If any VAD is functioning well and there are no signs and symptoms of any complications, I would not hesitate to allow a short term catheter to dwell beyond this 30 day limit. CDC Guidelines specifically state that there is no optimal dwell time known for any of these catheters. 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
I have left CVC's in place (specifically Arrow's coated TLC) for weeks (29d is the longest dwell I recall). If the patient requires central access and there is no s/s of infection, why replace? Especially if they are a renal patient where you should not use their arms. Consider looking at Arrow's JACC product - Coated CVC with extended dwell indication (Disclaimer - I work as a consultant for Arrow) but my comment was made as a clinician.
Regards
Judy