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Marianne
Locking w/ CathFlo

I know this has been mentioned before on this post (I just search for it); however, I was hoping that since it has been a few years since it was brought up I would ask for more recent input.  We have a patient (home infusion) that has multiple myeloma s/p bone marrow transplant.  She has a 3-lumen Arrow PICC and developed HIT while being treated.  She is currently flushing each lumen w/ 10ml NS daily.  Needless to say we are having patency problems.  All of the lumens flush but obtaining a blood return has been difficult.  Of course we can increase the flush to at least 2 to 3 times a day and hope it works.  We just admitted her on Tuesday and did not have any blood return from any lumen and one lumen was difficult to flush.  CathFlo was instilled yesterday w/ success.  My nurse had to go back today for more blood work...no blood return and had to use CathFlo again.  While this patient was in the hospital the PICC was flushed 3 times a day but not even 12 hours after being discharged home there was no blood return from the 3 lumens. 

Has anyone ever used CathFlo as a locking solution?  In past posts it was reported that this type of use for CathFlo is off-label (I have not researched it yet...next on my list).  Any suggestions on what to do w/ this challenging pt?  We will increase the frequency of the flushes but if there is something else anyone can suggest I would be greatly appreciative!  Thanks!!

 

Marianne Valentine, RN, BSN, CRNI

Nurse Manager, PharmaCare Infusion Services

Cumberland, MD

lynncrni
I gave a presentation at

I gave a presentation at WoCoVA last summer on alternative locking solutions. And the new Infusion Nursing Standards of Practice contains a list of alternative solutions and the associated references for each solution. The problem is that none of these are commercially available in a prefilled syringe in the US at this time. You must have a compounding pharmacy prepare them for you. See Standard 45 Flushing and Locking, page S59-S63. I am so glad to have all of this research in a published reference now!! Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Marianne
Thanks Lynn

I have been anxiously awaiting the arrival of the new standards...cannot wait to get them.  Thanks so much for your help. 

We can compound here so I will definately show our pharmacist the list and references then contact the physician to try and help this patient's PICC remain patent.

 

Marianne Valentine, RN, BSN, CRNI

 

Marianne Valentine, RN, BSN, CRNI

Nurse Manager

PharmaCare Infusion Services

Cumberland, MD

Rodney Allen
Why does she need a triple

Why does she need a triple lumen?  I would change it out with a single lumen.  Bet it will flush smooth as butter and easier for the patient to take care of rather than having to flush 3 lumens.  I find triple lumens clot off faster and only put them in for critical ICU patients.

Marianne
Good question

Not sure why they put in a triple lumen except for the fact she is a transplant pt and they decided not to change it before discharge to home.

Marianne Valentine, RN, BSN, CRNI

Nurse Manager

PharmaCare Infusion Services

Cumberland, MD

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