It was reported by the customer, 'patient uses powerpicc 2 lumens for chemotherapy and would like a maintenance manual.What i need to know is whether there is an indication to unblock the catheter that was already installed and was being used for chemotherapy and that was blocked for both aspiration and infusion.' (b)(6) 2023 additional information provided the power picc was placed in (b)(6) 2022 on patient's msd.The first aspiration and flush were done 3 days after placement and then every week.From the first maintenance i realized that there was difficulty in aspiration, sometimes it was blocked for aspiration.The nurses performed a small infusion of saline solution and the aspiration started again.I started to realize that during the flush the patient complained of pain and discomfort in his arm.Sometimes more, sometimes less.In december, i found instructions on the bd website to replace the catheter in case of difficulty in suctioning.I questioned the medical team about the difficulties encountered in aspiration and was confronted with the nursing team who denied any difficulty, but obviously it was not normal to pull the plunger of the syringe all the way back and not see blood.Then, on january 6, the catheter was completely and definitively blocked.The nursing team called the catheter specialist doctor who determined that they proceed with a maneuver to try to unblock it using a medication and a standard operating procedure that was presented to me.I questioned the use of this procedure and was convinced that i should try to unlock it, as the procedure invoked a vast bibliography.The procedure was performed and still did not unlock.Withdrawal proceeded.A new catheter is scheduled for placement on the next wednesday, the 18th.Four bevacizumab infusions were performed during this period.The infusion difficulty resulted in pain and it is very difficult to convince the patient to continue the treatment.There was no difficulty in the removal or need for exams.The catheter was removed and should be replaced next (b)(6).For the implantation of a new catheter, it will take place in a surgical center and hospitalization for one day.Additional information received (b)(6) 2023: the installation of a new catheter was postponed without forecast.
|