6 year-old male well-nourished patient receives IV fluids nightly with D10 ½ normal saline 1000 ml over 12 hours. Mother pages on-call provider concerned that Broviac might have come out 3 cm. Patient is asymptomatic. Next visit is scheduled for 1 week.
What is the next step?
A. Reassurance and check X-ray at next visit. Consider scheduling outpatient Broviac re-wiring if needed.
B. Emergency referral to surgery for central line replacement
C. Change IV fluids to normal saline due to danger of hyperosmolarity.
D. Stop IV fluids.
E. Order Tissue plasminogen activator (tPA)