RE: Groshong PICCS

[Lynn Hadaway]

Title: RE: Groshong PICCS

I am very interested in your success but let me see if I understood you correctly - by using only the push-pause (aka turbulent) method to flush your catheters, your occlusion problems decreased. Did you collect any outcome data on this? I really hope so! This technique has absolutely no scientific evidence to support its use. All published articles discuss theory of fluid flow only. No one has ever published any outcome data with this technique that I have found. Now others are beginning to question if this technique causes the disruption of biofilm which leads to a higher rate of CRBSI. One prevailing thought at present is that biofilm produces CRBSIs when it breaks off and floats freely into the bloodstream. It makes perfect sense to me that a turbulent flushing technique can cause the biofilm to break. Lynn

At 12:53 PM -0500 1/16/06, Ward Gina wrote:

We use Groshong Piccs and did have alot of trouble with occlusions when we started.  What we found was we were using the "heparin lock hubs" from Baxter, they have so much dead space that when you took out your syringe after flushing it, it created a negative pressure to fill up that dead space up top, and opened the valve at the end at pulls in blood so all the space is filled with some fluid.

 

 

Our quick remedy,( After talking with our Bard clinical resource nurse)  was to encourage positive pressure (push pause) flushing technique while flushing and withdrawing your syringe as well as changing to the CLC positive pressure caps.  Even before we changed to the CLC caps we no longer had any problems.

 

Gina Ward R.N., C.P.A.N.

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From: [EMAIL PROTECTED] on behalf of [EMAIL PROTECTED]
Sent: Fri 1/13/2006 3:34 AM
To: Erickson, Wendy; [EMAIL PROTECTED]
Subject: Re: Groshong PICCS

Wendy,
First the Groshong PICC does not have a clamp.  Second I use Positive pressure caps with my Groshong PICC's all the time.  They valve closes after the positive pressure is performed.   The three way valve opens and closes with positive and negative pressures.  If you flush the catheter the valve opens outward and if you draw from it the valve opens inward.  After you flush no matter the cap you use whether it be a non-positive pressure cap or a positive pressure the valve will close as designed.  I have been using the Groshong for well over a year and I have not had one catheter clot off not one.  I guess I lose money on re-insertions (LOL) but patient satisfaction and and customer satisfaction are more important to me.  Not trying to sell Groshongs just use them and like the way they last.  Now the company do not get me started.
Randy

--
Randy Ross R.N., B.S.N.
IV Nurse Consultant,
President & C.E.O.
IV's Etc...  LLC
Vascular Access
    & Consulting
Ph: 317-541-6463
Fax: 317-894-7709
Email: [EMAIL PROTECTED]
Website: www.IVsEtc.com

 -------------- Original message ----------------------
From: "Erickson, Wendy" <[EMAIL PROTECTED]>
> A quick question for the group.  We stress positive pressure flushing
> with our non-Groshong PICCs.  Does positive pressure flushing and
> clamping cause a Groshong valve to stay open?  (We don't use Groshongs,
> but a patient in a local nursing home has one that was placed elsewhere
> and the staff asked me the question).
>
> Thanks!
>
> Wendy Erickson, RN
> Luther Midelfort - Mayo Health System
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-- 

Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861