I know we have discussed this before, but I am sure there is some new and more recent data that you could direct me to.Â Upper Extremity thrombosis r/t picc linesÂ seem to be the number one concern right now with our physicians and I need to find some studies that provide current treatment regimens, recommendations etc for this.
I am aware of the patients that pose high risk factors for development of thrombosis (obesity, trauma, cancer, pregnancy, bed confined etc) and am also aware that with the technology of MST and the use of ultrasound, we have made great strides in reducing and identifying these, but still need some info to provide to my physicians who are concerned about the placement of picc lines due to this risk.Â Recently one physician informed me that it was nothing personal against us or the use of picc lines, it was just that lawyers are tearing them apart when it comes to DVT's.Â They need info on treatment measures (should we leave in if partially occlusive and treat with anticoagulants or pull the line).Â Our neuro physicians are very reluctant to use picc lines because the majority of their patients are NOT candidates for anticoagulants and they don't want to take the chance on a thrombosis. I also realize that catheter selection can play a part in this, but I am quite positive that this is not the case with us.
One theory I have is that with the development of a dedicated picc team in our facility a little over 3 years ago, we have provided a large amount of education to our nurses regarding the care and maintenance of all central lines, to include picc lines.Â With this new knowledge, were these DVT's there before and nurses were just ignorant to the fact to inquire about them or is there truly an increase in this problem?
I have included an article I recently came across and would like some input and thoughts from you.Â Any ideas, studies etc. would be greatly appreciated.