Pulling epidural catheters

[dabears505]

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Anyone actually seen a hematoma or bleeding from pulling an epidural catheter. Anytime it was done with unknown coagulopathy? Recently had a case lady kept her catheter in a few days due a coagulopathy but wondering if complications actually arise.

 

[pgg]

Anyone actually seen a hematoma or bleeding from pulling an epidural catheter. Anytime it was done with unknown coagulopathy? Recently had a case lady kept her catheter in a few days due a coagulopathy but wondering if complications actually arise.

Never seen it. Risk is probably vanishingly small. Kids with no platelets get intrathecal chemo, administered by non-anesthesiologists using the sewing machine needle placement method, and they don't bleed.

If you pulled an epidural and something DID happen though, it'd be hard to defend. Just leave it those few days.

 

[UscGhost]

Never seen it. Risk is probably vanishingly small. Kids with no platelets get intrathecal chemo, administered by non-anesthesiologists using the sewing machine needle placement method, and they don't bleed.

If you pulled an epidural and something DID happen though, it'd be hard to defend. Just leave it those few days.

This.

Unfortunately we are prisoners to guidelines. Just look at the preop GLP1 debate/debacle..

 

[IlDestriero]

Never seen it. Risk is probably vanishingly small. Kids with no platelets get intrathecal chemo, administered by non-anesthesiologists using the sewing machine needle placement method, and they don't bleed.

If you pulled an epidural and something DID happen though, it'd be hard to defend. Just leave it those few days.

Exactly. The platelet cut off for IT chemo at our children’s hospital is 10. We use a cut off of 30 for anesthesia. IR uses 50. For OB it’s 100, though OB has additional bleeding risks. There’s no data to support any of it that I’m aware of other than, “That’s what we agreed upon and it seems to be ok.”