Complete catheter occlusion

Complete catheter occlusion (using a standard ANTT® approach)

Statement	Complete catheter occlusion is when there is an inability to infuse any solution into the catheter together with the inability to aspirate any blood from it. Complete occlusion can result from thrombotic and non-thrombotic causes. A thrombotic complete occlusion develops as a result of a build- up of blood within the catheter. If a thrombus within the line is suspected, practitioners should use the troubleshooting guide below.
Troubleshooting	Withdrawal of blood and flushing has already been attempted (see appropriate templates). No kinks/clamps occluding the catheter. Ask the patient to take a deep breath in and hold whilst attempting to aspirate the catheter. Try altering the position of the arm and/or 30° head down tilt. If clamps are present, move clamp further down the catheter then roll the previously clamped section in your fingers gently to ensure that the catheter walls are not ‘stuck together.’ Prior to administering Urokinase, an x-ray may be obtained to verify the correct position of the catheter in a blood vessel.
Timing	This should be conducted in a hospital environment and must always be prescribed.
Procedure	If all troubleshooting procedures have been carried out with no success, patient should be discussed with NHSGGC.
Aftercare	Record in patient notes and CVAD bundle. Ongoing care and maintenance should be undertaken.