I know that there has been a lot of information on the list re Cathflo and declotting catheters. We are in the middle of rewriting our P&P, and I have been asked to find out what is actually being done other places. I have the information from the COOL 1 & 2 studies, the Cathflo rep, from the forum, the downloads, and other sources, but there are still some people that are insisting that every port without a blood return needs to have a dye study. Any information on what your actual practice is would be welcome.
The specific questions that I have been asked to ask:
Do you treat Ports the same as other central lines?
Do you routinely do a dye study or CXR before attempting Cathflo?
Are you more apt to request a CXR or dye study for an oncology patient?
Do you ever mix cathflo in an IV bag and drip it in, or always use a syringe method.
 Thanks,
Gail
I'm curious as to why they would want to treat these lines differently . . .
We attempt declotting with tpa as a first step UNLESS there are other indications that the port has other problems, e.g. pain somewhere on the chest with flushing or edema. In data I was keeping on declotting, ports and PICCs were our most frequent lines that needed declotting, and were declotted successfully with one or two tpa doses.
The specific questions that I have been asked to ask:
Do you treat Ports the same as other central lines? Yes
Do you routinely do a dye study or CXR before attempting Cathflo? No
Are you more apt to request a CXR or dye study for an oncology patient? I can't say that for sure.....it depends on patient S/S, but believe we would be more likely to start with a CXR.
Do you ever mix cathflo in an IV bag and drip it in, or always use a syringe method. We do both, depending on whether it is a total or a partial occlusion.
Alma Kooistra RN CRNI
Gina Ward R.N., C.P.A.N
I am a one man picc team here in our small hospital. I get called to help deal with ports that they have problems with.
I also deal with them the same as an occluded picc line. I look for any external causes, internal causes; abnormal complaints, symptoms, occurences etc, I do look at there recent cxr to check for "pinch off " etc. I also , usually remove the huber needle and re access myself. I do not get any dye studies unless something "red flags" me. I have gotten dye studies after being unsuccessful with cathflo.
I have great success with cathflo in our facility. Of course I am always trying to educate staff because I feel alot of these occlusions could have been prevented.
I have never done cathflo in a drip. I always do it in the syringe method as documented in the package insert.
thanks, Gina Ward R.N., CPAN
Gina Ward R.N., VA-BC
We do not perform dye studies or CXR's prior to using Cathflo. If the Picc position has changes(which we can easily see by looking at the cm markings) we would make decisions based on that, rather than doing a CXR.
We have not done cathflo via a drip- always a syringe. Nurses throughout the hospital have been trained
We treat all ports the same
I have not seen Oncology treated differently
Gail McCarter, BSN,CRNI
Franklin, NH
Thanks to those that responded. I think I have won this battle,and dye studies will not be required by policy before cathflo is given.
Now I have to convince those surgeons to get the tips on the ports in the lower third of the SVC to prevent some of these problems.
Gail
Gail McCarter, BSN,CRNI
Franklin, NH