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Caution: Always review hospital or unit protocol, potential
complications and their treatment, warnings, and precautions prior
to undertaking any type of mechanical or chemical intervention in
response to catheter performance problems.
Warning: Only a physician familiar with the appropriate techniques
should attempt the following procedures.
INSUFFICIENT FLOWS:
The following may cause insufficient blood flows:
•
Occluded arterial holes due to clotting or fibrin sheath.
•
Occlusion of the arterial side holes due to contact with vein
wall.
Solutions include:
•
Chemical intervention utilizing a thrombolytic agent.
MANAGEMENT OF ONE-WAY OBSTRUCTIONS:
One-way obstructions exist when a lumen can be flushed easily but
blood cannot be aspirated. This is usually caused by tip malposition.
One of the following adjustments may resolve the obstruction:
•
Reposition catheter.
•
Reposition patient.
•
Have patient cough.
•
Provided there is no resistance, flush the catheter vigorously
with sterile normal saline to try to move the tip away from the
vessel wall.
INFECTION:
Caution: Due to the risk of exposure to HIV (Human
Immunodeficiency Virus) or other blood borne pathogens, health
care professionals should always use Universal Blood and Body
Fluid Precautions in the care of all patients.
•
Sterile technique should always be strictly adhered to.
•
Clinically recognized infection at a catheter exit site should be
treated promptly with the appropriate antibiotic therapy.
•
If a fever occurs in a patient with a catheter in place, take a
minimum of two blood cultures from a site distant from
catheter exit site. If blood culture is positive, the catheter must
be removed immediately and the appropriate antibiotic therapy
initiated. Wait 48 hours before catheter replacement. Insertion
should be made on opposite side of original catheter exit site, if
possible.
•
Once an .018" guidewire has been introduced into the target
vein, the 4F sheath dilator should be threaded over the
proximal end of the wire and inserted into the target vein.
•
When the 4F sheath dilator is located in the target vein, remove
the guidewire and dilator one at a time.
•
Insert an .038" guidewire into and through the sheath until it is
located in the target vein.
•
Remove the sheath and continue following directions starting at
#13.
Warning: Only a physician familiar with the appropriate techniques
should attempt the following procedures.
MICRO PUNCTURE INSERTION METHOD
CATHETER REMOVAL
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