Pt woke up with missing NC. Picc line completly occluded. Dressing intact, site fine, line still needed for 3 weeks. Do you try to salvage it by using Cathflo to clear and then monitor for BSI or do you remove?
Be very thankful that lumen occlusion from a thrombus is what happened. If not that, he would have had a very serious air embolism and may not have survived in the middle of the night. Scrub the luer locking threads, add a new connector and treat the clot, hoping it will work for a long thrombosis like this. Closely observe for all signs and symptoms of BSI. There is no evidence about this but this is the consensus among other infusion clinicians. I would not remove it until I know there is a problem. Contact the provider and let them know what happened. Teach the patient/family what needs to be disconnected, what remains connected and how to tell the difference.
Be very thankful that lumen occlusion from a thrombus is what happened. If not that, he would have had a very serious air embolism and may not have survived in the middle of the night. Scrub the luer locking threads, add a new connector and treat the clot, hoping it will work for a long thrombosis like this. Closely observe for all signs and symptoms of BSI. There is no evidence about this but this is the consensus among other infusion clinicians. I would not remove it until I know there is a problem. Contact the provider and let them know what happened. Teach the patient/family what needs to be disconnected, what remains connected and how to tell the difference.
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
Thank you so much!!