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Kelly Smith
picc removal versus anticoagulation
What are most people doing in regards to thrombosis and picc lines?  If the patient has a swollen extremity in which a picc line is indwelling, and a vascular scan identifies a clot in that extremity, are most of you seeing the picc being removed or anticoagulation begun with the picc in place? 
Daphne Broadhurst
At our facility, upon

At our facility, upon ultrasound dopplar verification of an upper extremity venous thrombus, a thrombosis team consult is requested. The majority of the time the line is left insitu and low molecular weight Heparin (i.e., dalteparin) is initiated, if indicated. If the patient's symptoms are exacerbated or not alleviated, or there is a concern re septic thrombophlebitis the line would then be removed.

Daphne Broadhurst
Desjardins Pharmacy
Ottawa, Canada

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