Hi! We have recently, in less than 1 month, admitted 2 infants to our home infusion service, both on Lovenox injections d/t clots following femerol line placements. This seems very unusual to us, but our population has shifted to more children since we have an affiliation with Riley.
My pharmacist and I would like to know if this is common and also are there any reference articles you can direct us towards. We would like to know if there is something that we need to be watching, or suggesting a change. One of the babies was 1 mo and the current one is 17 mos.
You pediatric nurses might have some knowledge of this. I appreciate anything we can obtain from any of you on the listserv. Thanks!!
annÂ
Where is the tip positioned for these catheters? If they are below the diaphragm, they are not considered to be a central venous catheter as the inferior vena cava is the desired location. As with the SVC, improper tip positioning can lead to more endothelial damage and more thrombosis.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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
Cheryl Kelley RN BSN, VA-BC
We had a "rash" of DVTs in children. Many doctors thought they were related to PICCs, but the review of the data proved that it wasn't the PICCs. PICCs were placed to treat the DVT. We had many of the DVTs related to femoral lines that were not central. There weren't x-rays that confirmed the tip location in femoral lines, but they were used as "central lines." Many of the DVTs were at the iliac area or otherwise indicating that they were not central.
Our intensivists responded with this review of info and try to get the femoral lines out as soon as possible.
Gwen Irwin
Austin, Texas