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Fri, 12/07/2007 - 21:09

dmitch

Confirming Cath Tip Location Prior to Use

I'm interested in not only hospital based, but ambulatory Infusion Centers practices regarding verification of catheter tip location prior to use on patients admitted with pre-existing central venous devices?Â I understand the need for verifying the catheter tip and trying to establish a reasonable policy or guideline regarding this issue.Â For example:Â "A chest xray should be obtained to determine the catheter tip location in patients admitted with previously placed central venous access devices if there is no record of one having been done in theÂ past 2 weeks and especially prior to vesicant infusions."Â Â Â Thanks much.

Mon, 12/10/2007 - 14:45

lynncrni

I think this is a reasonable

I think this is a reasonable policy that will promote patient safety. I would even go so far as to remove the part about one being done in the past 2 weeks. We have had discussions about this at our INS chapter meetings and most hospitals represented automatically repeat chest xrays on every patient coming in the door with an existing catheter of any kind. There are several reasons. Activity can lead to catheter tip migration, thus you would be infusing into the IJ or contralateral subclavian. Also, some home care companies continue to place midclavicular catheters, even though we know they are not recommended. Once inside the hospital, you could receive orders for any number of fluids that requires infusion only through a properly placed tip in the SVC. It is far better to know where that tip is before you infuse anything. 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

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