Re: FAS procedure

[Jennifer Kettle]

I was figuring that this would be the most popular response.   :-) I have been a nurse for almost 10years and had never heard of it until I came to this hospital. (which is in Bend, OR) FAS is not an acronym. That is the actual name. This procedure is done when, for example, a nephrologist is concerned with the flow rate and/or concerned about possible contamination of a hemodialysis catheter. A "FAS endoluminal brush" is used under sterile technique and the internal lumens of the catheter are brushed. It is an actual very tiny brush and we literally put it into the catheter and literally brush it out. The hope is that we will get a culture of whatever may be growing and the other thought is that we can save the patient needless replacement of these dialysis lines r/t decreased flow rates by opening up the lumens. We send the brush for culture. We also have been known to perform this procedure on tunneled catheters in oncology patients. It is a very time consuming procedure usually r/t trying to figure out what size of brush to use as it varies not only with product but also with each patient as the internal length can be totally different from one patient to the next. Trying to figure out what a physician did during insertion is often difficult. For a tunneled catheter you must know how much external length there was along with internal length. And, often times, the brush will not go the entire length that we would like it to r/t for example, possible tunneling to the IJ vs. the subclavian, and the brush being too stiff to get around that bend. The procedure is supposedly with minimal complications. However, it makes me nervous as what are we releasing just doing the actual brushing??? So, that is what it is in a nutshell. Here is an excerpt from a website:       FAS Endoluminal Brush The FAS™ Endoluminal Brush addresses the problem of the unacceptably high replacement rate of Central Venous Catheters (CVCs). Although CVCs do become infected, the unnecessary and costly removal of the majority of such catheters can be attributed to shortcomings in traditional methods of diagnosis and patency management. The FAS™ Endoluminal Brush is a unique device designed to improve diagnostic accuracy and patency management without catheter sacrifice thus preventing both patient morbidity and unnecessary cost. | Website - FAS Medical International |   >>> <[EMAIL PROTECTED]> 3/9/2006 5:07:33 AM >>> OK ....I have been in IV nursing over 14 years.......but I give up. What is FAS???     -------------- Original message -------------- From: "Jennifer Kettle" <[EMAIL PROTECTED]> Hello again!   Needing yet more input and assistance. Are any of you performing the FAS procedure out there on a regular basis? We have been doing it in the past but have found ourselves having trouble maintaining our competency with the procedure as we do it so infrequently. Usually done on the hemodialysis catheters but have done it on some tunnled catheteres, piccs, etc. Is there evidnece out there to support routine use of this procedure for catheters vs. only intermittently? Thanks again.   Jennifer Kettle, RN, BSN