I got a call from a home health RN asking for me to replace a PICC line on an outpatient. After a little discussion she had drawn labs and flushed it that AM, but the antibiotic infusion was sluggish. She had changed the end cap etc. but I said before I would replace the line they should try cathflo and possibly a chest xray. She called the infectious disease doc who refused to allow the cathflo, only wanted the PICC removed and another one placed ( 3 more weeks of antb). She was, at this time, sending the patient to another facility to have this done. I spoke with the nurse at the other facility and she said this was not uncommon. That she can't tell me how many times she had replaced lines without EVER trying cathflo for this doc. Am I missing something?? I find cathflo so effective that I would never not try it. SHould I change my thinking??
You are perfectly correct in your thinking, yes try cathflo first, why subject the patient to another procedure, which has its own risk and cost, this doctor needs education.
Is there any nurse out there who is willing to share there protocol on extravasation of vesicant drugs, i.e. application of cold, steroid cream , manual injection of antidote.