Recognizing Occlusions

Ensuring catheter patency is vital to delivering life-sustaining therapies

Central line function should be routinely assessed

Occluded catheters may be responsible for interruptions in therapy, delays in discharge, or additional procedures, such as catheter replacement. 5,11

Learn to recognize the signs of central venous access device (CVAD) occlusion, which can include 1,11:

  • Inability to withdraw blood or sluggish blood return
  • Sluggish flow
  • Inability to flush or infuse through the CVAD
  • Frequent occlusion alarms on electronic infusion device
  • Infiltration/extravasation or swelling/leaking at the infusion site

In adult patients, with a blood flow through the SVC of approximately 2 liters per minute, a free-flowing blood return should be readily achievable. 14  Lack of blood return or a sluggish flow may indicate a catheter occlusion or a malpositioned tip, and further assessment of the line will be necessary. 1

A CVAD that exhibits any of these signs requires further assessment and possible treatment. Note that, according to the AVA Best Practice Guidelines, the risk of occlusion is higher for pediatric patients than in adults, because of the use of smaller catheter sizes, lower infusion rates, and significantly smaller lumen volumes. 2,11

AVA=Association for Vascular Access; SVC=superior vena cava.

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The INS Infusion Therapy Standards of Practice state that catheter salvage is preferred over catheter removal for management of central venous access device (CVAD) occlusions.1