pediatric picc occlusion

Specialties Infusion

Published

Have any of you heard about this method to reopen a blocked PICC line? I just saw this done on an 18 month old's dual lumen PICC line where one of the lumens was completely blocked. You connect a 10cc empty syringe and pull back. Clamp. Remove syringe. Connect a 2nd 10cc empty syringe, pull back, clamp, remove syringe. Do the same with a 3rd 10cc empty syringe. Next connect a 3cc syringe of heparin and try to slowly infuse. This procedure worked. It sure beat using TPA. But I've never seen or heard of this method before and want to know how safe it is and if any of you are familiar with it. Thanks.

Specializes in Maternal - Child Health.

I have never seen this done, and would also want some concrete information regarding its safety.

What is the concentration of the heparin that is infused?

The heparin was in a pre-filled flush syringe. I do not know the concentration she was using... didn't think to ask.

Specializes in ER, ICU, Infusion, peds, informatics.
have any of you heard about this method to reopen a blocked picc line? i just saw this done on an 18 month old's dual lumen picc line where one of the lumens was completely blocked. you connect a 10cc empty syringe and pull back. clamp. remove syringe. connect a 2nd 10cc empty syringe, pull back, clamp, remove syringe. do the same with a 3rd 10cc empty syringe. next connect a 3cc syringe of heparin and try to slowly infuse. this procedure worked. it sure beat using tpa. but i've never seen or heard of this method before and want to know how safe it is and if any of you are familiar with it. thanks.

well, heparin doesn't dissolve clots, it only helps to prevent new clots from forming, so it didn't have anything to do with the heparin. (when you anticoagulate someone with a dvt/pe with heparin, you are using the heparin/lovenox/fragmin/coumadin....whatever, to keep the clot from getting bigger, giving the body time to dissovle the clot. none of these meds have thrombolytic properties.).

[color=#483d8b]i'm not sure why it worked -- could have been a coincidence. or, the line could have been blocked by a fibrin tail, and manipulating it could have popped the tail off of the end of the picc, causing it to no longer block the lumen (though not dissolving it). if this is the case, the line will probably re-occlude pretty soon.

[color=#483d8b]i've had piccs become "declotted" the second i instilled the tpa. i know tpa doesn't work that fast, so something mechanical was going to to declot those piccs.

+ Add a Comment