At our hospital, we remove the majority of non-tunneled CVC's.
It has been our practice to ask an MD to d/c a CVC if there is a thrombus in that vessel, on the catheter, or in a nearby related vessel. I've had a couple of physicians (who didn't want to have to d/c them, or were unfamiliar with CVC d/c in one case) who wanted to know why.Â
I would like to find guidelines and research about the issue of embolization during d/c of catheters - for my/my patient's benefit, and for our facility. I'm sure we've d/c'd CVC's that had thrombi on them or nearby, without knowing it. Unless the MD preferred to leave the catheter dwelling during anti-coagulation rx, what different techniques for d/c'ing such catheter would be used, if any, for a line with related thrombus?
Anyone have suggestions?Â
Mari Cordes RN
IV Therapy Team
Fletcher Allen Health Care Burlington, VT
There are no established recommendations about the best method for treating a catheter related thrombosis. Not all cause a PE but this is a distinct possibility. There is no difference in the process for removal with our without a CRT. In fact, you have probably pull many catheters that have a CRT and just did not know it. If there is signs and symptoms of PE, then you must be prepared to appropriately intervene.
Catheter-directed thrombolysis is probably one of the best methods for treating CRT. Lynn
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