The Guide To Infusion Related Complications Occlusion In Hospice

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In this article, we will review the signs and symptoms, intervention, and preventative measures of occlusion in hospice patients.

Occlusion Definition

Condition in which the catheter is filled with blood or a precipitant preventing solution flow.

Signs and Symptoms of Occlusion

  • 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

Intervention

  • 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 (IV team available for iv starts)
  • 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 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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