At our hospital, we remove the majority of non-tunneled CVC's.
It has been our practice to ask an MD to d/c a CVC if there is a thrombus in that vessel, on the catheter, or in a nearby related vessel.Â I've had a couple of physicians (who didn't want to have to d/c them, or were unfamiliar with CVC d/c in one case) who wanted to know why.Â
I would like to find guidelines and research about the issue of embolization during d/c of catheters - for my/my patient's benefit, and for our facility.Â I'm sure we've d/c'd CVC's that had thrombi on them or nearby, without knowing it.Â Unless the MD preferred to leave the catheter dwelling during anti-coagulation rx, what different techniques for d/c'ing such catheter would be used, if any, for a line with related thrombus?
Anyone have suggestions?Â
Mari Cordes RN
IV Therapy Team
Fletcher Allen Health CareÂ Burlington, VT