Forum topic

4 posts / 0 new

Fri, 11/07/2014 - 21:01

TerryF

CVC

Understand that the CDC does not recommend dwell times, and FDA has cleared coated CVC's for <30 days.
Wondering how many are placing this into their policy?
I have a patient who had an IJ placed due to two unsuccessful attempts to pass a PICC, left and right side. The line is the Arrow with chloraguard and silver coating, not the JACC. The patient has no S/S of infection, patient needs the line I want to save that line and change my policy. I see no reason to pull the line at this time, only 10 days old. The MD is going by 10-14 days.
Thoughts, advice???
Thank you,
Terry

Sun, 11/09/2014 - 17:36

lynncrni

This is NOT a recommendaion

This is NOT a recommendaion for the dwell time of the catheter. Less than or more than 30 days are the 2 classes of catheters as outlined in the guidance document written by the FDA for manuafacturers seeking to submit a product for 510(K) clearance. No clinical data is required to enter either class of catheters. I would not consider these classes as having any influence whatsoever on the allowable or actual dwell time for any VAD of any kind. All VAD removal should be based on clinical signs and symptoms of all complications and the need for infusion therapy. There are no recommendations for optimal dwell time for any VAD. 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

Mon, 11/10/2014 - 20:01

(Reply to #2) #3

TerryF

Dwell time

Thank you Lynn,

But I am still a bit confused or maybe slow. I agree with clinical signs and symptoms as well the need for the catheter, so would it be correct to state- Central Venous Catheter may remain in place no greater than 30 days dwell time if no S/S of complications and a continued need for therapy? We are reintroducing the IJ catheter at my facility (CRNA placing them) and do not want the catheter pulled in 10-14 days, as was our policy with non protective coatings. Just trying to update policy to reflect our practice.

Thank you for your help

Tue, 11/11/2014 - 16:39

lynncrni

I would forget any specific

I would forget any specific time limiations and base the removal on 2 factors:

1. completion of infusion therapy

2. presence of any clinical sign or symptom of any complication.

According to CDC there is no optimal or recommended, or maximum dwell time for any type of VAD. Lynn