If you have ever seen the play “Fiddler on the Roof” you know that one of its central observations is about tradition. Tradition can be a good thing. It makes everyday life a little less complicated because we don’t have to think about the why of our action.
But tradition can become a problem if it prevents us from adapting to change when called for. Indeed, in a hospital setting, sticking to tradition can cause health issues that leave patients worse off. In some cases, it can even be deadly.
If it’s known that a change in practice could have prevented problems, it seems reasonable to say that failing to make the change reflects a level of negligence in care delivery. And in Oregon, in cases where it can be shown that the standard of care wasn’t met, the right to seek compensation exists.
This observation stems from some recent studies by researchers at the University of Michigan Medical School and with the Department of Veterans Affairs. The upshot of the work is that doctors and hospitals now have some new guidelines on how to decide what kind of intravenous delivery system to use with a patient.
Researchers found that one of the most commonly used IV systems, known as peripherally inserted central catheter or PICC, can also carry with it an increased risk of blood clotting at the site of insertion. The clots can lead to blockages of the line. That can cause pain and block medication and nutrition. If the clots break loose and travel to the lungs, they can create a deadly pulmonary embolism.
After looking at PICC use records on more than 900 patients in 2012 and 2013, researchers found that nearly 270 of them developed associated clots. But they also found that the risk of clotting was lower when narrower PICC lines were used or when patients were on blood-thinning or cholesterol-lowering medications prior to insertion.
This leads the authors to conclude that doctors should be more cautious in using PICCs, be more watchful for clotting if they are used, and make sure that the line is removed before any operation is performed.
They also say patients should not be afraid to raise questions if an IV is to be used.
Source: The University of Michigan, “Serious risks from common IV devices mean doctors should choose carefully,” Kara Gavin, March 27, 2015