Mobility with femoral mahurkar/CVC

Specialties Critical

Published

Hi there! My unit is working on a progressive mobility project. I am curious what you all are doing regarding progressive mobility for the STABLE patient who still may have a femoral Mahurkar/CVC (non tunneled) line in (we see a lot of OHT pts who have lost IJ/subclavian vein or axillary access second to scar tissue).

I have found a few (4) good mobility research articles with positive results for the patient with a femoral arterial line in but I can't find anything specific to a Mahurkar/CVC with femoral access. What are you thoughts?

Mine are: results are positive for the few research articles out there for mobility with a femoral arterial line. If the line is sutured in and most are even capped more often than not (Mahurkar), why not? Sure we worry about bleeding, hematoma, infection, line kinking but are these thoughts justified?

The patient with a Mahurkar/CVC line could even go home with it for short term access (18 months, I think) but these are tunneled in I believe--a bit more secure and is better for infection prevention I have read. I think the newer catheters are more flexible, but maybe I am wrong.

I would love to hear what your units are doing for this population!

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Specializes in Trauma Surgical ICU.

Femoral lines are kept in place for no longer than 24 hours if possible. Usually places in emergent situations ie trauma or code situation. Many are placed as a last result and switched as soon as possible to a PICC if long term use is needed or TLC if short term use is needed.

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This I know. Many of the OHT pts or burn pts do not have many access site options. I am talking stable patient, with no other choice but a femoral line, short term. Are you letting them dangle, stand, up to chair, even ambulate? Especially if the line is capped--maybe needing one or two more doses of IV ABX or a short run of HD before discontinuing the line.

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We don't let any of our fem line patients out of bed, not even to dangle. They can sit up in bed. I would say that virtually all still need pillows for support...in other words, they are not sitting up with their back off the surface of the bed. But I am MICU/SICU. I'd have to ask our burn nurses what they think.

Interesting question!

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They are not allowed out of bed at my workplace. HOB to 45 degrees max I believe (might be 30, haven't had this situation crop up in some time). I did work at another hospital where transfers to the BSC were allowed, depending on the doctor.

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Usually people who get fem lines are pretty sick and we needed access fast, bare minimum movement in my opinion. I have seen some septic/AMS/ETOH withdrawal patients almost kick them out. It really should be in only a day but I don't work with burn patients...

Rather have a PICC or IJ

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We get Large Bore femoral lines occasionally as temp HD access. These patients can be ambulatory.

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