Re: Positive Pressure Caps & Opened Ended PICC Lines

[Heather Nichols]

Legal commentary would depend on the type of complication.  Things that are costly and time consuming happen several time a day on a daily basis in the hospital without anyone ever hardly even noticing.  As a matter of fact, if they all resulted in "legal" complications, there would not be a single hospital still in business.      We thought to remove the clamps from our piccs when we started using the CLC2000 so that if anything did happen to the picc, such as an unremovable occlusion, the warranty supplied by CLC would not be voided by clamping.  CLC will replace the picc for free if you cannot remove an occlusion that happens when using their positive pressure cap, but not if it can be proven that it is related to clamping.  After we found a few problems from this, we quickly changed it and started leaving the clamps in place while doubling up on education about them.  We now use a different picc that does not require a positive pressure device.  The new picc has also dramatically reduced our occlusion rates, therefore we can also assume, knowing what we know about thrombus and infection growing hand in hand, we have possibly helped to reduced the possibility of line infections.     New products will continually be made.  Thank God.  Some will be magnificent and some will fail, but if not for new technology, we would be in a sorry state, so lets stop bashing it and stick to the evidence we find while using it.  We are all professionals here.  Positive pressure caps are a great idea.  We need to improve on that idea now.  All ideas welcome and none will be considered stupid.  Any ideas?    Heather Nichols RN BSN CRNI Infusion Services University of Louisville Trauma Institute 530 S. Jackson St. Lou. Ky. 40202 (502)562-3530 >>> <[EMAIL PROTECTED]> 01/29/06 9:27 AM >>> I know the answer to this question but would like some Legal commentary on PICC Nurses who "remove" the clamps to protect the patient and their PICC from staff who flush and clamp "incorrectly" resulting in costly and time consuming complications    -- Robbin K. George RN Vascular Access Resource Alexandria Hospital Virginia   -------------- Original message -------------- From: "Dee Gary" <[EMAIL PROTECTED]> Thank you Lynn, that is what I suspected!!!   Dee Lynn Hadaway <[EMAIL PROTECTED]> wrote: It sounds to me like this rep is using unnecessary scare tactics to sell his product. However, there are many hospitals that prefer to have the catheter extension leg clamped during periods between infusions. When using a positive displacement needleless connector, clamping immediately will prevent the internal mechanism from working properly. In other words, the fluid held in the connector reservoir will not inject the refluxed blood out of the catheter lumen because the clamp is closed. The answer to this is to teach your nurses to wait a little bit of time after flushing and before clamping. This allows time for the positive fluid displacement to occur and then the catheter can be clamped. Lynn At 6:04 AM -0800 1/28/06, Dee Gary wrote: I have a question for both groups:   A medical device sales rep has been telling us that using positive pressure caps (i.e. CLC 2000, Ultrasite, etc.) with open ended PICC lines, which have clamps on the extension legs, are a safety concern.  He states that if a nurse forgets to clamp the extension leg, and the positive pressure cap comes off, then a bleed out situation could occur and this is a safety concern.   Can anyone that has had experience using positive pressure caps with open ended PICC lines please validate what we are being told?   Thank you very much!   Dee                 Do you Yahoo!? With a free 1 GB, there's more in store with Yahoo! Mail. -- 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 Bring words and photos together (easily) with PhotoMail - it's free and works with Yahoo! Mail. ----------------------------------------------------- Confidentiality Disclaimer This message, including any attachments, is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law, including PHI (Protected Health Information) covered under the Health Insurance Portability and Accountability Act (HIPAA) of 1996.  If you are not the intended recipient(s), you are notified that the dissemination, distribution, or copying of this message is strictly prohibited.  If you receive this message in error, or are not the named recipient(s), please notify the sender or contact the University of Louisville Health Care I.S. helpdesk at 502.562.3637 to report an inadvertently received message. -----------------------------------------------------

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