I have a situation that home care is requesting. Dual lumen pic so that they can have one lumen just for blood draws. I can understand if the pt has a continuous infusion, but we are scratching out heads at this request. Where can I find literature re: more lumens increase thrombosis and infection risk?
ms redsuzy
I hope they aren't asking for a dual "Just in case one clots off" Just my experience. I agree with your head scratching. For intermittent therapy one lumen should be fine. The more lumens, the greater the risk of infection.
There is so much literature that clearly states the size and number of lumens are related to thrombosis and infection. I'm actually reading the MAGIC study right now for a presentation, along with a pile of other great articles.
1. Chopra V, Flanders S, Saint S, et al. The Michigan appropriateness guide for intravenous catheters (MAGIC): results for a multispecialty panel using the RAND/UCLA appropriateness method.
2. Chopra V, Anand S, Hicker A, et al. Risk of venous thromboembolism associated with peripherally inserted central catheters: a systematic review and meta-analysis. Ann Intern Med. 2015;163:S1S39.
Here’s two articles other great articles published in 2014 you can download from the AVA website if you're a mmber.
1. Clemency B, Manvel R. Risk factors associated with catheter-related upper extremity deep vein thrombosis in patients with peripherally inserted central venous catheters: literature review: part 1. J Infuse Knurs. 2014;37:187-19.
2. Clemency B, Manvel R. Risk factors associated with catheter-related upper extremity deep vein thrombosis in patients with peripherally inserted central venous catheters: a prospective observational cohort study: part 2. J Infuse Knurs. 201;37:260-268.
Good Luck!
We are moving away from using all CVADs for drawing blood samples. 2016 INS Standards contains reference to an article in home care that documented higher rates of BSI when CVADs were used for this purpose. This requires a risk v benefit assessment. If the CVAD is the one and only option, and the infusion therapy is intermittent, you should be able to draw between infusion time. If the draw is for therpeutice drug monitoring for the infused drug, make certain there is lots of flushing between drug and draw. See phlebotomy standard in INS Standards 2016. 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