![]() ![]() It doesn’t occur with peripherally inserted central catheters (PICCs) because they’re inserted in the arm and approach the superior vena cava from inside the vessel. It may occur with acute, tunneled, and implanted lines placed via the subclavian vein. Pinch-off syndrome is a serious complication requiring immediate attention. A more lateral catheter insertion allows the catheter to travel within the sub¬clavian vessel. As the patient raises and lowers the shoulder, repeated compression and shearing forces put pressure on the catheter. replacing it.Īnother cause of internal cathe¬ter occlusion is pinch-off syndrome, in which the catheter passes through the areolar tissue of the space outside the vessel lumen and becomes compressed between the clavicle and rib. ![]() If you suspect an internal occlusion, consult the ordering physician or licensed independent practitioner, who will weigh the risks and benefits of keeping the catheter in place vs. Causes include lodging of the catheter tip against a vessel. Internal occlusions occur inside the patient and are harder to assess. tubing and pump for obstructions and malfunctions. Check whether any clamps are activated, and look for sutures or a securement device that could be pinching the catheter too tightly. External occlusions stem from a kink or clamp in the portion of the catheter that’s outside the patient. Mechanical occlusionsĪ mechanical occlusion can be external or internal. Have a qualified clinician assess catheter-tip location from a recent X-ray, if available. Next, assess catheterpatency: Does the catheter flush easily, or only with difficulty? Do you see a blood return? Finally, Evaluate the patient’s medication profile for drug incompatibilities. Determine if blood return is hampered by the position of the patient’s arm or other body part (when either lying or standing). If you suspect your patient’s catheter is occluded, assess the entire infusion-delivery system for obstructions and kinks. About 40% to 50% of occlusions are nonthrombotic and result from mechanical or postural factors, medication precipitate, catheter malpositioning, or undesirable catheter-tip location. An occlusion can be thrombotic or nonthrombotic (not caused by a thrombus). Catheter occlusionsĪ catheter occlusion occurs when a blockage prevents caregivers from flushing the central line or aspirating blood. It also provides assessment, prevention, and troubleshooting tips for central lines. This article discusses potential complications-catheter occlusion, bleeding and hematoma, catheter-tip migration, catheter rupture, phlebitis and associated pain, swelling and deep vein thrombosis (DVT), infection, and embolism. To promote positive outcomes, clinicians caring for patients with central lines must monitor carefully for signs and symptoms of complications. ![]()
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