Chemo should always be piggybacked into a free-flowing gravity
drip of plain fluids without additives for the purpose of frequently
assessing catheter and vein patency. The quality of the drip will
change if an infiltration/extravasation occurs and you can easily
check for a blood return frequently. However, I don't get their
perception that they can not do this through a PICC? Are they saying
that gravity infusions can not drip due to the fact that there are
more occlusion with the PICCs? Cancer patients are hypercoaguable and
thus more prone to vein thrombosis especially in the presence of any
VAD.
For any issue related to flushing, I would refer you to the
May-June issue of the Journal of Infusion Nursing and the new article
I wrote on Technology of Catheter Flushing. Lynn
At 7:33 PM -0500 5/9/06, Gwen Irwin wrote:
I have recently been asked about giving chemo through a "free-flowing" IV related to PICCs. We have one of the hospitals with an oncology floor that believe, since we have changed to saline only flushing, they can't give chemo via free-flowing IV fluids via a PICC. They report that this is the case after the PICC has been in for a few weeks. They also report more occlusions that occur with PICCs. I am checking the actual number (of occlusions) for comparison before and after saline only flushing. I have offered inservices related to proper flushing (that has been effective on other floors that had a rapid decline in their occlusions, after inservicing).
Has this chemo issue that they report been anyone else's experience? I am debating how to answer their question and their request for heparin to be added to flushing policy for their population of patients.
Thanks for any help.
Gwen Irwin
Austin, Texas
--
Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
