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.
CATHETER PERFORMANCE
-4-