I would replace the line if every lumen could not be restored. I certainly agree that restoring only one lumen is not a good resolution. Patient will be back to endogenous levels in 30 minutes. 7 ml depending on the gauge/length.ĭosing less than 2mg in patients above 30KG may lead to partial resoultion and more frequent repeat occlusions.Ĭathflo's half life is about 5 minutes. Most PICC intralumenal volumes range from. So it is assumed 3 ports is the most which would allow for a max of 6 doses in one 24 hours period.ĭose/port should be 2 mg or 110% of the intralumenal volume if patient is less than 30KG. You can dose multiple lumens at one time with a max of 2 doses per lumen per 24hrs. I would advocate for the manufacturer's guidlines. As Lynn alluded to, you have policy that doesnt match Genetec's dosing instructions. Also Cathflo is not indicated for midlines. How do you know if it's a central line, midline, mal-posisitioned? I would never trust any report.always do in-house verification. If your goal was to use the existing line,įirst step.xray. Don't expect them to make this decision based on anecdotal information. obtained via the proximal, medial, and distal ports of a triple-lumen catheter. Finally, if this is happening a lot, I would investigate why? And if the 4 mg or 2 dose max per day is not working, take it back to your appropriate committees to re-evaluate but bring your outcome data to that committee. CVP measurements have been compared at different port sites of a triple. The distal end of a PICC line catheter should reside in the lower 1/. There may be concerns about the accuracy of CVP measurements from the proximal lumen of a CVC instead of the distal lumen. The proximal is the brown cap and is used for blood draws, the distal (white cap) is the port used for infusions like TPN and the medial port is used for routine fluids and IV meds on a pump. It does you no good, IMHO, to treat only one lumen and leave the other occluded as this would still pose a risk of BSI, thrombosis/emboli, etc. If I remember correctly, the triple lumen has a proximal, medial and distal port. I would treat both lumens, but one at a time. There are a number of important pieces of equipment here, and their uses will become clear as we walk you through the steps of placing a multilumen catheter. Demonstrated below is a triple lumen catheter set. If I thought this was a thrombotic intraluminal occlusion, I would try Cathflo first. The limitation of multilumen catheters is that you cannot feed invasive tools such as pacemakers or pulmonary artery catheters through them. The last is only done with a chest xray, would be needed especially if there are s&s for tip migration. I would always look at the history of what led up to the occlusion - types of fluids, meds that had been given, investigate about the flushing practices between meds, flushing resistance, presense or absense of blood return, confirm catheter tip location, signs and symptoms of tip migration, to rule out drug precip problem or change in tip location. A venous blood gas can be obtained from the distal port of the central line, a chest x-ray can be performed, and central venous pressure can be obtained from the distal port. Centers for Disease Control and Prevention.The maximum dose has been set by your hospital policy and not by the instructions from the drug manufacturer. In addition to dynamic ultrasound guidance, three methods ensure that a central venous catheter is placed correctly. O’Grady NP, Alexander M, Dellinger EP, Gerberding JL, Heard SO, Maki DG, Masur H, McCormick RD, Mermel LA, Pearson ML, Raad II, Randolph A, Weinstein RA (2002) Guidelines for the prevention of intravascular catheter-related infections. Infect Control Hosp Epidemiol 9:206–208Īrmstrong CW, Mayhall CG, Miller KB, Newsome HH Jr, Sugerman HJ, Dalton HP, Hall GO, Gennings C (1986) Prospective study of catheter replacement and other risk factors for infection of hyperalimentation catheters. So the lumen that opens up at the very tip-end of the catheter - thats the distal port, because it opens the farthest away from the insertion point. distal parts of the coronary tree when compared with computed tomography and. J Intraven Nurs 16:167–194įarber BF (1988) The multi-lumen catheter: proposed guidelines for its use. proximal descending aortic arch, a 3 sign as indentation at the site of. PowerPICC Catheter Dual-Lumen Basic Tray, 6 Fr. Nursing Care Guidelines 1:1–40īaranowski L (1993) Central venous access devices: current technologies, uses, and management strategies. PowerPICC Triple-Lumen catheter Full Tray with Sherlock Stylets, 5 Fr. Arrow International (1996) Arrow multiple lumen central venous catheter.
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