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Paula Happel
Factor VIII through SOLO PICCs
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!!
lynncrni
I do not think your problem

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

coffeemania
I always flush the PICC with

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?

coffeemania
I always flush the PICC with

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?

Gwen Irwin
I think that CathFlo is

I think that CathFlo is about $80 per dose.

Gwen Irwin

Timothy L. Creamer
SOLO flushing instructions

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

Paula Happel
Thanks for responses, but

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

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