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lynncrni
Catheter Repair

Catheter repair is an old topic that use to get lots of discussion, but has virtually dropped off my radar in the past few years. I would like to know the thoughts of those that are doing catheter repair and those that are not. Why and why not do it? Do you have a written policy and procedure about this? Who is allowed to do it in your facility? Any thoughts, issues, concerns, whatever you may want to share, I would like to hear. A traditional literature search shows virtually nothing on this issue. Thanks, Lynn

Craig Farris RN CRNI
Catheter Repair

Lynn,

I agree I haven't repaired a PICC in quite some time.  In my opinion it is due to the proliferation of the MST.  What used to be a repair is now a modified over the wire exchange if appopriate.  I also think that the PICCs are stronger at the hub now, where I saw most breaks.  The wide spread use of Ultrasound and placing the PICC above the AC space has reduced line trauma.  This all being said I did get called recently to repair a Groshong tunneled cath. 

We do have a policy that addresses this.  I think the two most important parts are that the Nurse must have PICC credentials and show competence.

The other key for my practice is that any PICC repair is only temporary.  Mostly because the repair has changed the terminal tip placement.  I also have infection control concerns from an exposed lumen. 

I agree I would like to see some documented numbers on this practice.  I wonder if it will become a lost skill. 

 

Craig

Craig Farris RN, CRNI

Clinical Nurse liaison

Barbara Tinsley
PICC repair

Gee Lynn,  I have not seen a PICC needing repair in ages.  We don't have a policy to address repair.  If I encountered it I would have to send them to IR because I don't even have a repair kit in my unit!!

Barbara Tinsley

Linda Tirabassi
catheter repair

I work with children. I still do catheter repairs for Broviacs and Groshong PICCs. However, I am not reparing the Groshongs at the rate that I had done in the past. The #3FR Groshongs were the ones requiring the most frequent repairs. We just have not had as many #3FR catheters in the past months. We do have a P&P for both PICC repairs and Broviac repairs. A nurse must demonstarte compentencies to do this procedure. The P&P also directs to obtain a bld culture when the catheter is fractured vs for a broviac (4.2FR) when the inner and outer catheter have only separated and an elective repair is done to avoid an total break in the catheter. Seems like the broviac repairs come in "clusters".

Linda

Donna Fritz
I think part of the reason we

I think part of the reason we don't do so many PICC repairs is the use of "power" injectible PICCs.  They are stronger, thicker-walled catheters and don't break as easily.  My own opinion is that, of the catheters I see, tunneled Groshongs would be the highest risk for needing repair.  But it's been a couple of years since I've had to repair one of these.

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