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PICC line related DVT prevention

We have seen PICC related DVTs on and off over the past year at our hospital, despite DVT prophylaxis being done with SQ Heparin 5000u every 12h or weight based Lovenox dose. The analysis we have done points to Passive ROM not being done enough, esp. on vented restained and/or decreased LOC patients. Now we can retrain staff to do more PROM.

Additionallly, does anyone have a DVT prophylaxis that will be different for patients with PICC line verse standard hospitalized patient not having a PICC line? My thought is we have standard DVT prophylaxis guidelines that every patient gets when they admitted unless it is contraindicated, but are these guidelines enough to prevent DVT's on our unconscious, vented sick critical ill patients. Would love feedback on this...

Tracy Ivory, RN, BSN, VA-BC, CRNI


 There are a few small

 There are a few small studies on using anticoagulant medications as prophylaxis when a patient has a type of CVAD. However there is no consistency among those studies and there are no published guidelines stating to use any type of anticoagulant to prevent catheter associated DVTs. CA-DVT at this time has been related to tip location and external diameter of the catheter. Sorry no other guidelines to share. Lynn

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

At AVA last year I heard a

At AVA last year I heard a talk that cited aspirin as a better preventative for device related thrombosis.  I don't have the references at hand however.

I recently saw a sequential compression device that fits on the sole of the foot designed for patients that have had bilateral saphenous vein harvesting.  I've wondered if that would work on the forearm of immobilized patients or possibly a pediatric leg SCD.


Darilyn Cole, RN CRNI VA-BC

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