How quickly can a blood clot travel?

Guttercat, ASN, RN · Feb 22, 2012

If a blood clot was dislodged during a peripheral IV flush, how quickly/ how long would it take for the patient to possibly die from a dislodged clot? Thanks!

Unlikely.

...you wouldn't believe the shite the IR guys push through when declotting a peripheral access...

KelRN215, BSN, RN · Feb 22, 2012

As in the other thread, I will encourage you to think about what is actually going on here. A peripheral IV catheter is SMALL. It is in a small vein and the blood flowing through this area is flowing into larger vessels. A 14 gauge is the biggest PIV you'll see in use and its diameter is only slightly larger than 1 millimeter. More likely, you'll be working with 22-24 gauges which have a diameter around 0.5 millimeter. Any clot that forms at the end of them is microscopic. If it's not causing them any problems in a teeny vein in the hand (other than difficulty flushing a PIV), what kind of trouble do you think it's going to cause in a large vein like the SVC?

Think about what the major concerns for clots are- MI, CVA, PE and DVT. Of these, only DVTs occur in the veins and those are primarily caused by immobility. MI, CVA and PE are all caused by a disruption of arterial circulation often because a clot forms in a large vessel and then blocks the smaller vessels.

I cannot imagine a situation where a microscopic clot at the end of a PIV would cause anything other than slight discomfort with the flush.

IVRUS, BSN, RN · Feb 22, 2012

Well,

Like another poster said, a small thrombus from a peripheral IV catheter usually won't cause the person harm. Small micro-emboli may develop for various reasons, but your body has a naturally occuring clot-buster: Urokinase which breaks them down. Larger clots, however can be a problem. And remember, when something is given into an IV catheter, it takes only around 23 seconds to reach ALL around the systemic circulation.

nurseprnRN, BSN, RN · Feb 22, 2012

pulmonary emboli usually originate in the venous side, travel to the right heart, and out the pulmonary artery to the lung.

systemic arterial clots, such as originate in a fibrillating left atrium, can travel out the aorta and then to anywhere in the arterial system. this is why atrial fib patients are on anticoagulants; af is a big risk factor for cva or other embolic phenomenon.

coronary artery clots that cause mi can originate in the left heart, as above, but are most often the result of clot forming inside the coronary artery on the rough and inflamed surface of a pre-existing plaque, or, sometimes, from a clot or bit of vegetation growing on a diseased mitral or aortic valve.

a small clot such as you would push off an iv catheter will strain out in the pulmonary capillary bed and dissolve there. do not worry about this so much any more.

Esme12, ASN, BSN, RN · Feb 23, 2012

and Remember if you encounter resistance......DON"T FORCE IT.

Double-Helix, BSN, RN · Feb 23, 2012

I still don't ever force a PIV if there is difficulty flushing. I've removed lines to find that there has been a back flow of blood into the lumen due to improperly saline locking the line. I've seen clots in the lumens that are a centimeter long. In a 20 gauge needle, and in a child, that's not a risk I want to take.