My institution gave our Regional PICC committee, to review, a guideline for "Ambulation of a Patient with a Femoral line (Vas Cath or central line)". Does anyone have any information, thoughts, or evidence towards this subject? What does your facility say about this?
Are you caring for adults or children and infants? Femoral catheters in infants are probably more common than older children and adutls. In infants, they are tunneled, cuffed catheters with the catheter exiting away from the insertion area. For patients with percutaneous CVADs inserted via the femoral site, there is concern about infection and malposition. Most organizations now recommend that femoral sites not be used for CVAD insertion. When used, the catheter tip location may or may not be confirmed by chest xray or ECG, although it should be confirmed and documented. To be consider a CVAD, the tip should be in the inferior vena cava above the diaphragm. There are numerous malpositions of femoral CVADs that can occur. See the Infusion Nursing Standard on CVAD Malposition with several references listed. In my opinion, I do not think that a femoral CVAD should be allowed to dwell long enough for the patient to be ambulating. If it is the one and only site for percutanous CVAD insertion during an emergent situation, it should be moved to a better location when the patient is stable. For a tunneled cuffed or percutaneous CVAD via a femoral site, I am not aware of any published studies looking at the outcome with ambulation. Let us know your impressions of the resource you will be reviewing. 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