Forum topic

5 posts / 0 new
Last post
Ann Williams RN CRNI
babies, lines, & clots

Hi!  We have recently, in less than 1 month, admitted 2 infants to our home infusion service, both on Lovenox injections d/t clots following femerol line placements.  This seems very unusual to us, but our population has shifted to more children since we have an affiliation with Riley.

My pharmacist and I would like to know if this is common and also are there any reference articles you can direct us towards.  We would like to know if there is something that we need to be watching, or suggesting a change.  One of the babies was 1 mo and the current one is 17 mos.

You pediatric nurses might have some knowledge of this.  I appreciate anything we can obtain from any of you on the listserv.  Thanks!!

ann 

lynncrni
Where is the tip positioned

Where is the tip positioned for these catheters? If they are below the diaphragm, they are not considered to be a central venous catheter as the inferior vena cava is the desired location. As with the SVC, improper tip positioning can lead to more endothelial damage and more thrombosis.  

Lynn Hadaway, M.Ed., RN, BC, CRNI

www.hadawayassociates.com

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Ann Williams RN CRNI
Good point Lynn....I looked
Good point Lynn....I looked them up and found that 1 is shown to have "tip overlying rt iliac bone" and the other shows the "central venous line projects over the L5 vertebral body to the rt of midline."  1 dvt was "within the common femoral vein or the rt superficial femoral vein", and the 2nd was "within the common femoral vein at the origin of the greater saphenous vein within the rt inguinal region."  Neither had the line long...one was 3 days and the other 2. 
afruitloop
? Traumatic insertion it
? Traumatic insertion it sounds like ?

Cheryl Kelley RN BSN, VA-BC

Gwen Irwin
We had a "rash" of DVTs in


We had a "rash" of DVTs in children.  Many doctors thought they were related to PICCs, but the review of the data proved that it wasn't the PICCs.  PICCs were placed to treat the DVT.  We had many of the DVTs related to femoral lines that were not central.  There weren't x-rays that confirmed the tip location in femoral lines, but they were used as "central lines."  Many of the DVTs were at the iliac area or otherwise indicating that they were not central.

Our intensivists responded with this review of info and try to get the femoral lines out as soon as possible.

Gwen Irwin

Austin, Texas

Log in or register to post comments