A Guide to Occlusion & Infusion Related Complications

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Definition

An occlusion is defined as a condition in which the catheter is filled with blood or a precipitant preventing solution flow.

Signs and Symptoms

  • Inaccurate flow rate is first sign of a partially occluded catheter
  • Infusion ceases as catheter becomes more occluded
  • Unable to flush

Contributing Factors

  • Solution container allowed to become completely empty
  • Positional catheter placement
  • Inappropriate flushing of catheter
  • Administration of incompatible solutions with precipitant formation
  • Kinked catheter or pinched administration set

Interventions

  • Do not flush an occluded catheter because of potential of pushing embolus into the circulation
  • Remove peripheral or midline and examine for integrity
  • Apply dry sterile dressing to site
  • Place new catheter site in opposite extremity if possible

For PICC’s and CVC’s Request IV Team to Assess

  • Obtain order for Alteplase (Cath Flow) 2 mg/2ml
  • Send collaborative request to infusion to declot catheter

Preventive Measures

  • Follow agency protocol for flushing catheter
  • Frequent monitoring of medication container. Change before container is empty
  • Use positive flush method (clamp or remove syringe during instillation of last ml)
  • Catheters should be flushed with 0.9% sodium chloride before and after medication to maintain patency

Reference

Core Curriculum for Infusion Nursing Third Edition. Lippincott Williams & Wilkins.

 

 

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