Is anyone aware of any evidence-based literature supporting any standards for catheter migration? At what amount of change should the physician be notified?
I appreciate any advice,
Peggy O'Keefe RN CRNI
Des Plaines, IL
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The new INS standards will have a new standard on catheter malposition that addresses both primary and secondary malposition. There is no specific catheter length withdrawal that can be stated as the hard rule for notifying the physician. You need to know the exact anatomical location of the catheter tip on insertion, the amount of catheter left external at insertion, document all changes in this external length. If this length changes, then you need to take action. Tip migration can be caused by only internal movement of the catheter or external movement. The SVC is usually ~7cm in length. Assess what fluids/meds are infusing and decide what action is recommended - chest xray to assess current location, signs and symptoms of malposition and their management, and possible exchange over wire or removal and insertion of a new catheter. But there is no specific length to provide you. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861