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Patti Atteberry
Subclavian catheters

I am very interested to see if any home infusion companies or home care companies are taking patients with subclavian catheters.  Are the patients long term, or do you have criteria for short term therapy?  Also does anyone know of any benchmarking comparing these lines to others with risks of infection and air embolism, etc.?

Thanks to all,

Ann Williams RN CRNI
Our home infusion company

Our home infusion company has taken pts with subclavian catheters.  We don't like subclavians, but they are typically very short term. We get some pts from a cancer center in  Louisville, KY and they use a quad lumen.  I have been told it is because of all the drugs they admin while pt is hospitalized.  The physician has us discontinue the line as soon as the home chemo is done, and then they place another one the next month.  They don't even want to leave it in to finish the round of labs that are being drawn. 

Except for these chemos, I cannot think when we last had a subclavian.  (we'll get one today now!) <g>  But we have not refused subclavians in the past, the nursing staff kniows to watch them closely and we have had no problems.

I know these lines are higher potential for infections and air embolisms, but I don't have any data.  Marcia Ryder presented at AVA once and demonstrated the growth of bacteria in the subclavian area vs antecubital area in a healthy person.  I can't remember the numbers, but definitely higher in the subclavian area.  Make sure your connections are luer locked to reduce risk of air embolism.

Hope this helps.

Kathy Kokotis Bard Access

Kathy Kokotis

Bard Access Systems

Do you mean tunneled or non-tunneled

Non-tunneled are a safety risk and not acceptable for home infusion.  They have no indication for a dwell time of over 30 days.

Bleed out, infection, air embolism. 

Even tunneled lines are a safety risk for air embolism and bleed out however they have indication for a dwell time of over 30 days


Kathy Kokotis

Bard Access Systems

Patti Atteberry
Patti Atteberry, RN,
Patti Atteberry, RN, CRNI
Manager of Compliance and Risk Management
OSF Home Care Services
I am referring to non-tunneled.  Thank you both for your responses.
Patti Atteberry, RN, CRNI
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