Positively bloody!

….as in  positive blood return when aspirating from central venous catheters (CVC).  Positive blood return means a free flowing blood return easily obtained on aspiration, and the color of whole blood. In other words, bloody RED, not pink-tinged. What a great feeling, knowing that the CVC is properly functioning and ready to use.Syringe_with_blood

NOT able to obtain a blood return from CVCs?  This might  indicate a problem.

  • If the tip of the CVC is in the lower thirds of the superior vena cava at the junction of the SVC and RA, then you should get a blood return. If you can’t get a positive blood return, do not use and assess the cause.
  • It is not an expectation for patients to do arm and shoulder movements or what most nurses refer to as “central line aerobics” while you aspirate for a blood return.
  • If unable to obtain a positive blood return, then there is a problem with the central line. Assess for possible drug precipitate, fibrin sheath, thrombus formation at tip of catheter, and mechanical problems such pinch-off syndrome, malpositioning of catheter tip, or catheter dislocation.

What if you call the physician and report the problem (inability to obtain blood return) and you are told to go ahead and use the CVC for infusion anyway. Should you?

Keep this in mind… Assessing for blood return is one of the key indications of a properly functioning CVC and  without a blood return, the use of the CVC can put the patient at risk of serious complications. 

A bloody reminder on Oct 31 – Happy Halloween to all!!!  Blood---Pumpkin---Grimace