Pt woke up with missing NC. Picc line completly occluded. Dressing intact, site fine, line still needed for 3 weeks. Do you try to salvage it by using Cathflo to clear and then monitor for BSI or do you remove?
Be very thankful that lumen occlusion from a thrombus is what happened. If not that, he would have had a very serious air embolism and may not have survived in the middle of the night. Scrub the luer locking threads, add a new connector and treat the clot, hoping it will work for a long thrombosis like this. Closely observe for all signs and symptoms of BSI. There is no evidence about this but this is the consensus among other infusion clinicians. I would not remove it until I know there is a problem. Contact the provider and let them know what happened. Teach the patient/family what needs to be disconnected, what remains connected and how to tell the difference.
Be very thankful that lumen occlusion from a thrombus is what happened. If not that, he would have had a very serious air embolism and may not have survived in the middle of the night. Scrub the luer locking threads, add a new connector and treat the clot, hoping it will work for a long thrombosis like this. Closely observe for all signs and symptoms of BSI. There is no evidence about this but this is the consensus among other infusion clinicians. I would not remove it until I know there is a problem. Contact the provider and let them know what happened. Teach the patient/family what needs to be disconnected, what remains connected and how to tell the difference.
Lynn Hadaway, M.Ed., RN, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thank you so much!!