[kraye]

what are you doing with picc lines that develop clots... we removed line anything else we should be doing?

[RADONC-RN]

We sometimes send them to Angio to see if they can declot them otherwise they just put in a new one.

[augigi]

They often get thrombolytics injected to dissolve the clot.

[augigi]

McKnight S. Nurse's guide to understanding and treating thrombotic occlusion of central venous access devices. 13(6):377-82, 2004 Dec

Over 5 million central venous access devices (CVADs) are placed in the United States annually. Catheter occlusion is the most common non-infectious complication in long-term use of CVADs. Nursing management of the thrombotic occlusion of central venous access devices is described. The normal process of hemostasis and fibrinolysis and common types of catheter thrombosis are reviewed, along with the step-by-step procedure for restoring catheter patency using thrombolytic agents.

[philly22]

Are you referring to a clot around the PICC catheter. And if so, is it an occlusive thrombus or a nonocclusive?

[kraye]

i am referring to a dvt clot..

[philly22]

For upper extremities that develop DVT's around the PICC line we remove the PICC line if it's an occlusive thrombus or if the MD requests the line to be removed. If it's a nonocclusive thrombus the line doesn't necessarily have to be removed. Warm soaks and elevation work well. As well as some form of anticoagulation therapy should be started if the patients' condition allows. Any other questions feel free to email me.

[dds520]

Alteplase with an order from attending. Works like a charm!

[rgroyer1RNBSN]

tenectaplase, heparin, and warm compresses. Or angio.