II. Indications
- Outpatient intravenous management
III. Complications
- Minor complications
- Entry site infection
- Phlebitis
- PICC Line port Occlusion (e.g. one port on a triple lumen catheter)
- TPA 2 mg reconstituted in 2.2 ml sterile water injected into occluded port
- Attempt aspiration and repeat attempt aspiration every 30 minutes for 2 hours
- If aspiration is successful, withdraw 4-5 cc blood, and then flush catheter
- If unsuccesful, may repeat the TPA injection protocol once as above
- TPA 2 mg reconstituted in 2.2 ml sterile water injected into occluded port
- Major complications
- Pulmonary Embolism (0.1% risk)
- Venous Thrombosis (2.5% risk)
- See PICC Line Thrombosis
- Higher risk with Amphotericin B (10x risk)
- May present as serous drainage from the PICC insertion site
- Ultrasound with high frequency linear probe starting at insertion site and scan up extremity
- Observe for clot and compressibility
- Any concerns should prompt formal Ultrasound