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Management of Central Venous Access Device Occlusion - Algorithm

Management of Central Venous Access Device Occlusion - Algorithm - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Clinical Practice Guidelines, Medications, Related




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Appendix B: Management of Central Venous Access Device Occlusion – Algorithm
Central Venous Access Device Occlusion – Adults/Pediatric Guideline

If a partial or complete occlusion is identified:
Assess for signs of
mechanical occlusion
Treatment:
o Reposition patient, forced coughs, deep breaths
o Remove add-on devices or replace clogged filters
o Change dressing, loosen sutures, open clamps to ensure no kinking or twisting
Patency Restored?
Assess for thrombotic occlusion Assess for chemical occlusion
Treatment:
o Alteplase 1 mg/mL
o Dwell 60 minutes
Patency Restored?
Treatment:
o Alteplase 1 mg/mL
o Dwell 60 minutes
Patency Restored?
Consult with MD:
o CXR
o Dye study
o CVC replacement
o CVC removal
Treatment:
Acidic Drug (pH < 6) – vancomycin, pipercillin
o 0.1 HCL

Basic Drug (pH > 7) – phenytoin, ganciclovir, ampicillin
o NA bicarb

Lipid
o Ethanol 70%

Dwell 60 minutes
Patency Restored?
No
No
Resume Use of
CVC
Yes
No No
Yes
Yes
No
CPG Contact for Changes:
Name: Philip J Trapskin, PharmD, BCPS
Phone Number: 263-1328 | Email Address: ptrapskin@uwhealth.org
Last Revised: 08/2014

Copyright © 2014 University of Wisconsin Hospital and Clinics Authority, University of Wisconsin Medical Foundation, Inc, UW-Madison