Our outpatient center currently has a Von Willibrand's patient receiving Factor VIII BID for 4 weeks post-op via a Solo PICC. We have had complete occlusion at least once and problems with blood return and sluggish flushing ongoing. We have used Cath Flo at least twice so far in his 2 weeks of treatment. We flush with 20cc saline after the infusion. We don't have any experience giving this over an extended period like this through a PICC. It does make sense if you ar giving clotting factor that it might clot around your PICC. I think it is crazy & expensive to keep giving Cath flo. Does anyone have experience with this scenario? Should we use heparin to lock the line?Thanks for any input!!
I do not think your problem is caused by the Factor VIII being infused. Do a search of this forum on SoloPICC to learn the experiences of others with this catheter.
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
I always flush the PICC with 10 mL NS in the middle of the blood/blood product transfusion. I personally see a huge difference the flush can make. I also a Heparin lock believer. But I believe that Lynn is right on that Solo.
How much is a shot of CathFlo? Anyone knows?
I always flush the PICC with 10 mL NS in the middle of the blood/blood product transfusion. I personally see a huge difference the flush can make. I also a Heparin lock believer. But I believe that Lynn is right on that Solo.
How much is a shot of CathFlo? Anyone knows?
I think that CathFlo is about $80 per dose.
Gwen Irwin
SOLO flushing instructions include performing a positive pressure disconnect with each saline flush, removing the syringe while flushing the last 0.5cc of saline. This will prevent the 2 aspiration valves from partially opening due to the negative displacement effect of disconnecting an empty syringe and refluxing blood at the distal catheter tip.
Effective blood return is obtained by performing the saline flush to verify patency then aspirate the syringe plunger to the 0.5 to 1cc mark and pause, maintaining negative pressure and allowing the valves to open. Aspirate blood slowly, aspirating aggresively will increase PSI within the catheter lumen(s) likely collapsing the lumen walls resulting in poor to no blood return and likely lysis of any specimen(s) obtained.
Hope this helps.
Timothy L. Creamer, RN
Clinical Specialist, Bard Access Systems
Florida Division
Timothy L. Creamer RN, CRNI
Clinical Specialist, Bard Access Systems
Florida Division
Thanks for responses, but I'm not hearing from people who have used Solo for intermittent factor VIII. I still can't help but think it is logical to expect more clotting/thrombus around the PICC after infusing clotting factor. It is supposed to arrest bleeding everywhere throughout the body. If a fibrin sheath has developed at the PICC tip- some of the factor could perhaps stay in/around the sheath long enough - despite flushing & make it close off exponentially faster than it would if it were an antibiotic infusion... doesn't that seem logical?
Paula Happel, RN, MSN
Mercy Medical, Cedar Rapids, IA
Paula Happel, RN, MSN
Mercy Medical, Cedar Rapids, IA