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SharonIVRN
SharonIVRN's picture
patient with clot around PICC, treat with heparin or remove PICC

have a patient with a clot around PICC line.  Sometime the team will treat around, other times PICC is d/c'd and placed in opposite arm.  Have not been able to locate any information in the INS standards.  What are everytones thoughts on this, what is your facility doing in regards to this? 

Thank you

Sharon

lynncrni
 I just finished revision of

 I just finished revision of the new INS SOP about this issue, so it will be addressed in the Jan 2016 edition based on recent recommendations from the literature. If the CVAD is functioning with a positive blood return, not resistance to flushing, and no evidence of infection, the recommendation is to leave the CVAD in place and do not remove it. There could also be therapeutic anticoagulants prescribed. Remval and insertion in a new vein will only cause the same thing in the new site. Also if the pain is severe from the thrombosis, the CVAD may have to be removed, but this should be the last resort. 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

SharonIVRN
SharonIVRN's picture
Thank you , Lynn! 

Thank you , Lynn! 

I believe this was also addressed in the recent MAVAN meeting.  Looking forward to the revised standards

Sharon

Sharon Irvin, RN, BSN

jill nolte
another article

David Bruce put this on a thread a while back: N Engl J Med 364:9 NEJM.org March 3, 2011 ppg 861-869

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