The Guide To Infusion Related Complications Occlusion In Hospice

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.

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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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