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PICC occlusion

Posted
disneylyn disneylyn (New) New

Visited the home of a patient today who has lumen #2 of his picc clotted for 5 days. HE also had a knot at the insertion site size of a marbel, complained of numbness and tingling in shoulder and supervisor upset that I wouldn't declot in the home. I felt patient needed xray or ultrasound to determine extgend of clot. I am soo mad first off that the nurse who saw him on Friday didnt think it was urgent to declot then or the very next day. Told patient to "wait till Monday and we will address then". GRRRR!!! Help? Lyn

IVRUS, BSN, RN

Specializes in Vascular Access. Has 32 years experience.

First,

Parasthesia of this extremity along with an occluded lumen definetly can point to thrombus, however, can this thrombus be dissolved with a 2 or 4 mg Cathflo dose? Probably not. Most inner lumen occlusions from fibrin build-up can be dissolved with Cathflo, but a thrombus large enough to cause the pt to be symptomatic needs investigation, which can't be done in the home. Also, what was the insertion site complication? Had a granuloma formed?

Send him out and have a complete diagnoses performed.