|
Managing Common
PICC Related Complications
Even though PICC related
complications are low, PICC practitioners and those
who care for PICC lines must know how to manage them.
Phlebitis:
In most instances, redness
and swelling around the catheter site is due to mechanical
or chemical irritation and is rapidly reversed. But
the site should be monitored for possible infection.
An aseptic technique during insertion and care, avoiding
catheters placement in areas of flexion, and simple
symptomatic treatment with analgesics and compresses
is usually adequate. However, if it persists and does
not resolve, another line may need to be cannulated
at a different site.
Catheter Occlusion:
Occlusions in the catheter
can occur from drug precipitation, fibrin formation
or thrombosis. Often it may be difficult to determine
the cause. Proper care with flushing regimes and techniques
can greatly increase catheter functionality. However,
even with the most religiously cared for PICC line,
instillation of a fibrinolytic agents may be necessary
and successfully treats any occlusion problem.
Infection:
The fight starts with
meticulous attention to cleanliness and aseptic technique
during all phases of PICC care. Once the PICC line is
successfully and sterilely inserted, the goal is to
continuously monitor for the presence of infection as
well as performing regimens with attention to maintaining
sterile technique when required. If an infection is
detected, the aim is to quickly localize the infection,
use of antibiotics, and removal of the PICC line if
necessary while closely monitoring for any progression.
Catheter Fracture
or Embolism:
This is sometimes noted
when the catheter leaks or when holes or breaks can
be visualized. However, occasionally only the tip breaks
off and migrates. This can cause symptoms like cyanosis,
tachycardia and a change in consciousness.
Air Embolism Emergencies:
Air embolism can cause
serious emergencies, as large amounts of air can enter
and lodge in the circulation, brain or heart chambers.
Although rare, a close vigil must be kept, and any signs
of chest or back pain, shortness of breath, hypotension,
tachycardia and a change in consciousness should require
prompt action.
Difficult Removals:
It is important not
to forcefully attempt to remove a PICC line. If the
line is difficult to remove, after allowing the patient
a considerable length of time to apply warm compresses
to dilate the vein, for the venospasm to resolve and
the patient to relax should it be reattempted. Venospasm
is often the cause which usually resolves with time
and warm compresses. Forceful removal can result in
vein or catheter rupture.
The consumer health information
on this Website is for informational and educational
purposes only and is not a substitute for medical advice
or treatment for any medical conditions.
|