What is everyone doing when CVAD does not give blood return however flushes easily and tip is confirmed per xray to be in SVC? We have used cathflo in these instances and sometimes still no blood return, it seems out of frustration doctors are writing orders to continue using the CVAD anyway. Does that put nursing staff in a potentially sticky situation? Any advice or history of same and what you did would be helpful.
Thank You
BJ Sherman, RN
The standard of practice states that you must have a positive blood return to confirm device patency prior to admin of meds and solutions. If I can't get blood return with Cathflo the first time, almost always the second dose works. If not, I change out the line, but that doesn't happpen very often. If it is a port-a-cath and cathflo doesn't work, also rare, then I let IR take care of it.
You bet it puts the nurses and the facility in a very dangerous liability situation. Your answer to those docs is a firm, polite, but emphatic no! There could be several reasons for this situation and a simple chest xray is not enough to properly diagnose the problem. I can tell you many horrible outcomes from legal cases where a blood return was not checked or not obtained. So just say NO! 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