You are dealing with 2 problems that generate blood reflux - syringe
reflux and disconnection reflux. Disconnection reflux has been
managed by one of 2 ways:
1- using a positive pressure flushing technique with all negative
displacement connectors OR
2- using a positive displacement connector
There is a huge question that is unanswered at the present time. Will
either of these methods overcome syringe reflux volume and the
disconnection reflux volume? If using a positive displacement
connector, the answer depends on the volume of fluid that is actually
displaced, which varies by brand.
When using the BD prefilled syringes, was this the BD Posiflush
syringes or their regular syringes? If BD Posiflush, then I can well
understand your problem when you switched to a regular syringe made
by Kendall. Now Kendall has redesigned their prefilled syringes to
overcome the syringe reflux problem. The design of the BD Posiflush
and the Tyco Kendall Monoject PreFill Advanced is different but both
accomplish the same thing to prevent syringe reflux when flushing
catheters.
I would bet that the syringe design and the use of positive pressure
flushing technique is the source of your problems. Lynn
At 11:39 AM -0500 6/8/06, DAVID LONGSETH wrote:
Last summer our hospital had to switch from BD prefilled NS syringes
to a Kendall product for flushing our PICC's. Since then,our
occlusion rate has gone way up,based on TPA usage. In Aug 2005,for
example we used 19 vials of TPA. Last month it was 30-some.
I am convinced that the new product is at fault. The cannula that
comes in the new package is thicker and longer than the BD one and
thus takes up more space in the cap when you flush,so when you pull
it out you create more of a vaccuum/dead-space in the lumen (It's a
split-septum style cap). It seems to me that this negative pressure
within the lumens is sucking in just enough blood to clot off the
lumen. The PICCs are 95% Groshongs,5% Bard PP's.
I asked that some samples of our product combination be sent to our
Bard rep so the company can maybe check this out but haven't heard
back.
Anyone with anything similar happen?
Regards
David
--
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
