We frequently have patients with temporary jugular catheters for stem cell collection. Once the collection is complete the catheter is removed. Currently have a pt with temp jugular. Tip placement is just above the junction of the jugular and subclavian. Is this catheter OK to use. My feeling is that it is probably ok to use only for cell collection, but absolutely not ok for administration of any medication. What are your thoughts. This patient had cell collection thru triple lumen temp jugular two days before I was consulted. Pt was receiving calcium drip and bolus thru this line (placemnent noted above). I am not comfortable giving any meds with this placement.
I would also be extremely uncomfortable to use any catheter at this tip location - above the IJ-subclavian junction. This is not a central venous location and should never be used as such. The risk of thrombosis has been studied in PICCs with tips located in this general area, but I have reservations about applying those studies to this situation. Length of catheter, vein curvatures, etc could have an influence on outcomes. However, this tip location with a large size stiff catheter inserted from the neck is from use of harvesting the stem cells only, in my opinion. You also did not say which jugular vein was used for insertion - IJ or EJ. There are different risk with each vein. EJ is much more tortuous so I suspect they are using IJ. Why are the inserters choosing to place the tip so distal? Why are they not using a catheter long enough to be a true central line with tip at the SVC/RA junction? Can you get them to change this practice? I would refuse to use those current caths for infusion because their is no evidence to support infusion through them. 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
You might also have problems with stem cell collection with tip that high. Optimal location is very important to acheive maximium collection.