when you are figuring out your thrombosis rate for PICCs, do you do it by number of catheter days (as in infection rate)? or do you do it per catheter insertion.
also, I am looking for an article/ study by the Radiologist who did a study where he duplexed all his patients before and after PICC insertions and found, i think, a 69% thrombus rate. Also think he was the MD who presented at last years AVA meet.
thanks,
Sharon
Boaz Markewitcz was the physician, (an intensivist, not a radiologist) might not be spelled correctly. You can purchase his presentation from the AVA web site, go to conferences, 2007, recordings, and it is number VA-R08.
The subject was also discussed in some minutes of meetings that I located on the CHEST journal web site. Try a goole search.
Cheryl Kelley RN BSN, VA-BC
Robert Armendariz
Kathy Kokotis
Bard Access Systems
Thrombosis was asymptomatic If I am thinking of the right study. Not sure what to do with asymptomatic thrombosis because we would be treating with coumadin 69% of patients with catheters in place.
The body breaks down clots naturally so we have never treated something we do not look for (asymptomatic clots). If we find an asymptomatic clot it is treated as that is what we traditionally have done. Treating 69% of patients does not sound feasible or maybe necessary. I have no magic answers to this one.
The SIR - Society of Interventional Radiology has a benchmark on VAD complications rates/ Acceptable Thrombosis symptomatic is 6% based on Number of patients (JVIR 2004 is where the article is in a supplement). Literature thrombosis they state is 3-4%. This is not a CMS never even like CR-BSI. Leg DVT is now on the list. Catheter DVT is not on the list. I suggest getting rid of all femoral catheters as leg DVT is now on the list and besides Femorals are bad.
To answer your question I would look at both catheter days and per patient and look at symptomatic.
kathy
Kathy Kokotis
Bard Access Systems
Kathy,
You don't happen to have a digital copy of that JVIR 2004 supplement do you? If you do....could you send it to me as an attachment?
[email protected]
Jeff Hanks, CRNI-Vascular Access Nurse, Oaklawn Hospital. Clinical Consultant, Boston Sceintific.
Jeff Hanks, CRNI-Vascular Access Clinical Specialist, Arrow International