Lines and Catheters

Foley Catheter

  • Chronic Foleys generally should be exchanged at time of admission
  • Duration of use is biggest risk factor for CAUTI; consider removal on rounds daily
  • Any concern for catheter obstruction (particularly with blood clots) should prompt urgent urology consult for irrigation/intervention (typically after RN has attempted)

 

PICC

  • Single lumen: long term ABx, stable IV access with intermittent draws
  • Double lumen: special populations (ICU or chemo), TPN w/ lipids (incompatible with many IV medications)
  • Risk factors for CLABSI/VTE: ↑↑duration, ↑↑number of lumens, left arm, lower extremity
  • Removal at earliest time possible is key to preventing complications; patient comfort is not an indication for prolonging use

 

G-Tube

  • Troubleshooting: EGS consult for malposition/not functioning, wound consult for skin breakdown
  • G-tube study: 30mL Gastrograffin via tube [resident often must push], and order KUB

 

Line Flushes

  • PIV: heparin 10u/ml
  • Central line: heparin 100u/ml