Does anyone have a guideline/policy at their institution that guides best practice in regards to how long these bigger Fr catheters (MACs) are left in place. The right catheter for the right patient at the right time. MACs are being placed at our facility more often - but the question arises if this short 10cm should be replaced as soon as pt is deemed hemodynamiclly stable to reduce risk of thrombi, vessel wall damage and a catheter that is way too short of the lower SVC.
Any information would be much appreciated so I can help develop guidelines at our facility.
Thank you,
SOD
This catheter should be treated the way you would addres any non tunneled CVC. These catheters are intended for trauma and surgery to achieve the high flow rates needed for those patients. It is not intended to be indwelling long term. However, keep in mind that triple lumen CVCs (non-tunnelled catheters) are also too short to reach the lower SVC in most patients, they only come in two lengths, 16 cm and 20 cm, and depending on thier insertion location wiill end in the upper or mid SVC.
This is a case where assesment by knowledgeable vascular access team is important---how long will the patient need IV medicatoins? Do those medications need to go through a central line or is a peripheral access adequate? You can right some guidelines based on the booklet instructions for use included with each MAC catheter, but keep them assessment based, patients and their vascular access needs are not always black and white.
Chris Cavanaugh, RN, BSN, CRNI, VA-BC