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Wed, 06/06/2007 - 21:31

lynn

bard powerpiccs and pumps

I have noticed that our bard powerpiccs are clotting off even when a infusion pump is on the port. the rate is less then 50/hr. and the positive pressure caps have been left on when the pump which has been working for days will suddenly alarm occlusion. any thoughts out there

Fri, 06/08/2007 - 13:50

lynncrni

That positive displacement

That positive displacement cap is not doing anything to keep the line patent while you have tubing from the pump attached to it. These device ONLY create positive fluid displacement when the tubing or syringe is detached from it. While it is attached, this catheter remains an open line. You did not say what mechanism of action is used by the pump. You also did not state what other meds or uses this catheter was used for. There is no established rate of fluid that that will "keep a vein open". If this continuous fluid is not required for therapeutic goals for each patient, then I would stop using it. I would use the correct flushing technique for the type of needleless connector being used in your facility. Finally, how do you know that these events are actually caused by a clot? Is this inside the vein or inside the catheter lumen? What is done to diagnose this problem. Signs and symptoms only or some other tests? There are many factors involved in catheter patency. 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

Mon, 06/11/2007 - 20:42

(Reply to #2) #3

lynn

last time this happened, the

last time this happened, the positive presurre cap was on infusion pump was running 37cc with cytarabine x7 days and this was day 5 when this happened . pt was awake and sitting in chair talking with wife. FN. unable to flush, placed infusion to other port. infusion continued. I was called up. with 10cc syringe,able to slowing infuse 3 cc. asked for open cath. instilled, it sat for 30 min. and whoosh wonderfull blood return, which I was not able to get before and flushed like a trooper.

Tue, 06/12/2007 - 08:46

(Reply to #3) #4

lynncrni

This could still be vein

This could still be vein thrombosis around the tip of the catheter inside the vein, not inside the catheter lumen. Your declotting procedure was enough to reach the clot at the catheter tip. This problem could reoccur because you have not reached the entire length of clot around the catheter's external walls. The positive displacement cap has no effect on this situation since the tubing was attached with infusing fluid. Lynn