first try gentle aspiration.... gently aspirate, then try to flush, gently aspirate and then try to flush... 9 times out of 10, i'll pull back a small fibrin strand and then i can discard that syringe and have another syringe with 5 cc nss and flush through... if gently aspiration does not work, then get an order for cathflo, 2mg/2ml to declot.
i usually ask for a md's order f, to include the drug and "may repeat x1"
99.9 % of the time, i get it open by direct connection and aspiration.
i was going to say that i have my patient in every position possible, straightening the arm, moving the arm up, down, anything to try to gentle aspirate, i have them sit, stand, lay and move the arm and try gentle aspiration, i straighten out the catheter. if nothing works our home health agency uses cathflo 2mg/ml. we insert the cathflo, wait 2 hours, and then aspirate the cathflo (5-10 cc blood) works well. i was told by the cathflo representative that came in and gave a presentation a few years ago that even if the cathflo is pushed in and not aspirated, it's not that dangerous. she said it was like taking 2 325mg aspirins. i have only had one patient that i could get nothing to work on, and i had to send her to the er to have the picc replaced as they could not get it to work either.