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Julie Mijatovich
SCD devices on PICC line extremities.

Our hospital has a new idea line. This idea came through.

Does anyone know of any research in this area? Pros/Cons.

"DVT associated w/ PICC lines are due to stasis/immobility. Try using SCD sleeves on arms w/ PICC lines to reduce DVT's assoc w/ PICC lines. "

Thanks in advance for your help.

Julie Mijatovich,CRNI

Parkview Health

lynncrni
What is SCD devices? Not

What is SCD devices? Not famililar with that abbreviation. Regardless of that, I would have to see the evidence to support this recommendation before I would be able to accept it or follow it. Did they provide any references? 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

Julie Mijatovich
SCD-sequential compression devices

Lynn,

They are sequential compression devices that are used for patients who lie in bed to prevent DVT's. I am not in favor of this at all. The chance of phlebitis I think is high. I have not found any evidence.

I wanted support to stop this from occuring here.

Thanks,

Julie

lynncrni
OK, now I know what we are

OK, now I know what we are talking about. These devices might be effective if applied only to the forearm, but again I do not know of any evidence to support their use. When you look at the causes of catheter-related thrombosis, this treatment does not match the causes - catheters too large for the vein lumen, improper tip location, inadequately stablized catheters allowing for dislodgement to smaller veins, tip migration due to changing pressures, plus all the hypercoagulable factors presented by the patient alone. These compression devices would seem to me to have the potential for increasing vein thrombosis because the compression will bring the vein wall into greater contact with the catheter wall, causing endothelial disruption and thrombus. Seems to me to be a very questionable, possibly dangerous off-label use of these devices. One the other hand, if the catheter is too large and producing obstruction to venous flow, the SCD on the forearm could prevent flow stagnation by increasing the flow through collateral vessels. But then again, we could prevent the entire problem by choosing a smaller catheter. 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

Karen Day
Karen Day's picture
Sequential Compression

Sequential Compression Devices that you usually find on the lower extremities.  One of my pulmonologists had this same idea, we have never trialed it but I am curious to see the replies.

 

MayVABC
It sounded as if we put a

It sounded as if we put a blood pressure cuff in a PICC's arm. I wouldn't want to try this SCD on the PICC arm. I agreed with Lynn.

afruitloop
This is a topic that I have

This is a topic that I have huge interest in.  I am gathering my data and will let you know what I find.  As per some of the patents on these devices, they reduce venous stasis....  Stais occurs simply from immobility, especially in the ICU population.  We see edematous extremities in this patient group quite frequently.  Let's complicate this picture even more and put a large lumened catheter in a peripheral vein, where stasis exists, and I think we have a serious combination.  but as I said, I will gather some data and report back.   Great topic! 

Cheryl

 

Cheryl Kelley RN BSN, VA-BC

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