Central Venous Access placement and exchange (Tunneled catheters, Ports)

PREOP EVALUATION

• No Clinic Visit
• Only send PT/INR if patient is on Coumadin – otherwise no labs

TIMING / BED REST AFTER PROCEDURE

1 hour

ANTICOAGULATION/ANTIPLATELETS

• Aspirin or Plavix:  Do not stop
• Lovenox, Low Molecular Weight Heparin (LMWH), Arixtra – Stop 24h prior to procedure
• Pradaxa – stop 3 days prior to procedure if possible.  See “Warfarin” immediately below for “bridge” anticoagulation, if necessary (CONTACT IR physician if uncertain)
• Warfarin (Coumadin) – Depends upon procedure and indication, as well as the reason the patient is taking this medication (CONTACT IR physician or PA)

LOCATION OF THE PROCEDURE

• Cath lab

PREOPERATIVE ORDERS

• If patient has renal failure or congestive heart failure, NO IV or IV fluids
• For mediports and lines for non-renal failure patients IV with NS (Normal Saline) 75ml/hr

FOLLOW UP

• Follow-up:  Call in 1 week to see if line/port is working adequately.
• If line or port needs to be removed, can be done in PAMF clinic under local anesthesia