How do you manage a catheter occlusion?

How do you manage a catheter occlusion?

The current standard treatment for CVC occlusions in the United States is instillation of alteplase with a concentration of 2 mg/2mL. A dose of 2 mL, or 110% of the volume of the catheter lumen if less than 2 mL (maximum dose 2 mg), is placed in the catheter lumen.

Why is subclavian vein used for catheterization?

Subclavian catheterization also carries a lower risk of catheter-related infection and thrombosis than femoral or internal jugular vein catheterization. Since Aubaniac’s original description in 1952,4 subclavian vein catheterization via the infraclavicular approach has become a well-established technique.

Why will the nurse place a patient in the Trendelenburg position for insertion of a subclavian non tunneled percutaneous central catheter?

For the internal jugular vein and subclavian, the patient should be placed in Trendelenburg position to increase the size of the vessel and improve the chance of first-pass success.

What is occluded catheter?

Catheter occlusion is the most common noninfectious complication associated with long-term venous access. Symptoms of a catheter-related venous thrombosis may consist of neck vein distension, edema, tingling, or pain over the ipsilateral arm and neck, and a prominent venous pattern over the anterior chest.

How do you prevent a catheter embolism?

1. Position the patient in a supine position.
2. Instruct the patient in Valsalva maneuver during the catheter removal process; if a Valsalva maneuver is contraindicated, have the patient exhale during the procedure.
3. Slowly remove catheter and place immediate pressure to the exit site until hemostasis is achieved.

What is subclavian catheter?

Central catheters provide dependable intravenous access and enable hemodynamic monitoring and blood sampling [1-3]. The subclavian veins are an often favored site for central venous access, including tunneled catheters and subcutaneous ports for chemotherapy, prolonged antimicrobial therapy, and parenteral nutrition.

What are CVC used for?

A central venous catheter (CVC), also called a central line, is a long, thin, flexible tube used to give medicines, fluids, nutrients, or blood products over a long period of time, usually several weeks or more.

How is a PICC line placed?

To place the PICC line, a needle is inserted through your skin and into the vein in your arm. Ultrasound or an X-ray might be used to confirm the placement. A small incision is made in the vein so that a thin, hollow tube (catheter) can be inserted.

What is catheter dislodgement?

Catheter dislodgement is a major cause of technical failures in intraarterial vasopressin therapy for gastrointestinal bleeding. Ten such cases were observed in the past five years. In seven patients catheter dislodgement led to recurrent bleeding during vasopressin infusion.

What is an occlusion?

An occlusion is a complete or partial blockage of a blood vessel. While occlusions can happen in both veins and arteries, the more serious ones occur in the arteries. An occlusion can reduce or even stop the flow of oxygen-rich blood to downstream vital tissues like the heart, brain, or extremities.

What are the risks of subclavian and femoral vein catheterization?

With subclavian vein catheterization, patients are at risk for pneumothorax, subclavian artery puncture, hemothorax, and hematoma. Risks of femoral vein catheterization include femoral artery puncture, which may cause a retroperitoneal hematoma; an increased incidence of catheter-related bacteremia; and venous thrombosis.

How many attempts of subclavian catheterization have been made?

Supraclavicular approach to subclavian catheterization: review of the literature and results of 178 attempts by the same operator. J Trauma. 1997;42:305–9. [PubMed] [Google Scholar]

What is the infraclavicular approach for varicose vein (SV) catheterization?

When utilizing the infraclavicular approach for SV catheterization, note that the SV arises from the axillary vein at the point where it crosses the lateral border of the first rib. The SV is usually 1 to 2 cm in diameter and fixed in position directly beneath the clavicle. It is separated from the subclavian artery by the anterior scalene muscle.

What are the advantages of the subclavian vein for central access?

Several anatomic advantages of the subclavian vein for central access include its large diameter, absence of valves, and ability to remain patent and in a relatively constant position.1,2Subclavian catheterization also carries a lower risk of catheter-related infection and thrombosis than femoral or internal jugular vein catheterization.3