I. V. ROUNDS: Managing complications of midlines and PICCs
LISA A. GORSKI RN, APRN, BC, CRNI, MS
LYNN M. CZAPLEWSKI RN, C, CRNI, OCN, BSN

$3.95
Nursing2014
June 2005 
Volume 35  Number 6
Pages 68 - 69
 
  PDF Version Available!

ABSTRACT
Outline

  • Warming up to phlebitis

  • Catheter occlusion: Clearing the way

  • Breaking up thrombosis

  • Fighting infection

  • Put the brakes on migration

  • Catheter fracture or embolism

  • Air embolism emergencies

  • Dealing with a difficult removal

  • SELECTED REFERENCES

    OVERALL, the complication rate for midline catheters and peripherally inserted central catheters (PICCs) is low, but you still need to know how to deal with problems. Here we'll discuss how to prevent some common complications and intervene if problems occur.

    Warming up to phlebitis

    An inflammation of the vein, phlebitis is characterized by redness, swelling, tenderness, and warmth along the catheterized vein and may have a mechanical, chemical, or infectious cause. Mechanical phlebitis usually occurs within the first week of catheter insertion and responds to warm compresses and arm elevation. Chemical phlebitis is triggered by the infusion of irritating I.V. drugs. Infectious phlebitis occurs when bacteria infect and damage the vein lining.

    Prevention: Don't infuse irritating solutions through a midline catheter. Avoid placing the catheter in an area of flexion and secure the catheter to prevent migration. Perform hand hygiene and use aseptic technique when providing site care and administering therapy.

    Interventions: Notify the prescriber. To treat mechanical phlebitis, apply warm compresses, elevate the arm, and give analgesics. Remove the catheter if signs and symptoms don't resolve or if phlebitis occurs after more than a week after catheter insertion.

    Catheter occlusion: Clearing the way

    Partial or complete catheter occlusion limits or prevents blood aspiration, flushing, or administering solutions or drugs. Occlusions can be nonthrombotic (caused by drug precipitates or mechanical ...

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