We've been seeing an increased need in Bard Broviac repairs due to twisting and pulling of the fine tubing leading to weakened line strength, separation of the inner tubing causing bubbling, or through and through holes. These patients often (but not always) come into the ER as outpatients with a short gut on home TPN who had less than stellar line dressing securement to protect that fragile tubing. Has anyone had any luck with a more sturdy line to switch to considering the long term need and potential harm from, blood loss, air embolism, and infection? Has anyone heard any plans Bard may have for improving the line's durability? Also any tried and true 1) methods of prevention 2) rules of thumb for numbers of repairs permitted etc
By using the trade name "Broviac", do you mean the pediatric sized tunneled cuffed catheter? Is the child the one doing this pulling and twisting? Tunneling to the upper back is a very successful method to keep this away from curious hands. I would start by contacting the manufacturer in their clinical department to ask for information. They would be the best resource for any changes that are being made. See the INS SOP Catheter Damage. There are no standards for the number of repairs that can be done, but each repair has to be done with a brand-specific repair kit following the manufacturer instructions closely. Each repair will not be as strong as the original catheter, but that is true for all brands.
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
Yes this is the specific type of line I am referring to. Often it's a result of the longer line that is typically coiled under the dressing becoming uncoiled and the thin/ less strong portion of the catheter (still a fair distance from the insertion site) is pulled by the patients normal activity so that it is no longer under the dressing and is unintentionally stretched or twisted and further weakened. Tunneling to the back sounds like a good option. I will try reaching out to the manufacturer as well.
FORHIM