thank you for the article info! we are currently using heparin for all central lines flushes also (Children hospital). When I took a VAD class about 4 years old (taught by Marcia Ryder), I think (if I remembered correctly) she mentioned that hep-locked central lines had lower infection rates.
--- Nancy Moureau <[EMAIL PROTECTED]> wrote: > What do you think of Darcy Doellman's research > article in the JPEN that > showed reduced infection rate with lines flushed > with heparin vs saline? > > > The Impact of Needleless Connector Device Design on > Central Venous Catheter > Occlusion in Children: A Prospective, Controlled > Trial > > Journal of Parenteral and Enteral Nutrition, Vol. > 30, No. 2, 2006 85-90 > C 2006 American Society for > <http://jpen.aspenjournals.org/misc/terms.shtml> > Parenteral and Enteral > Nutrition > Susan Schilling, RN*, Darcy Doellman, RN, BSN*, > Nancy Hutchinson, RN and > Brian R. Jacobs, MD > > >From the * Division of Home Health Care, Infectious > Diseases, and Critical > Care Medicine, Cincinnati Children's Hospital > Medical Center, Cincinnati, > Ohio > > Background: Intraluminal occlusion is common in > children with central venous > catheters (CVCs). Although multiple factors > predispose CVCs to occlusion, > reflux of blood is frequently implicated. We > hypothesized that use of either > a single-valve or positive-pressure-valve needleless > connector device would > reduce CVC occlusion rates in comparison to a > standard device. We further > hypothesized that saline would be as effective as > heparinized saline flush > in preventing occlusion and infection. Methods: CVC > lumens were > prospectively capped with 1 of 3 needleless > connector devices in a 4-group > design. Group 1 lumens were capped with a standard > device, group 2 with a > single-valve device, group 3 with a > positive-pressure-valve device flushed > with heparinized saline, and group 4 with a > positive-pressure-valve device > flushed with saline. Data were obtained regarding > occlusion and infection > rates and user satisfaction. Results: Three hundred > sixty children with 599 > CVC lumens completed the study. Complete occlusion > occurred in 19/150 > (12.7%) lumens in group 1 in comparison to 2/150 > (1.3%) in group 2, 5/149 > (3.4%) in group 3, and 6/150 (4%) in group 4 (p < > .05). There was a trend > toward a 2-fold greater infection rate in group 4. > User satisfaction was > higher in groups 2, 3, and 4 than group 1 (p < .05). > Conclusions: CVCs > capped with a single-valve or > positive-pressure-valve needleless connector > device have lower complete catheter occlusion rates > than those capped with a > standard device. Heparinized saline flush affords no > advantages over saline > in reducing occlusion rate; however, there was a > trend toward lower > infection rate with the use of heparinized saline. > > Nancy Moureau, BSN, CRNI > PICC Excellence, Inc. > 888-714-1951 > <http://www.piccexcellence.com/> > www.piccexcellence.com > <mailto:[EMAIL PROTECTED]> > [EMAIL PROTECTED] > > -----Original Message----- > From: [EMAIL PROTECTED] > [mailto:[EMAIL PROTECTED] > On Behalf Of Kokotis, Kathy > Sent: Tuesday, September 26, 2006 5:22 PM > To: Chris Cavanaugh; Denise Macklin; venous > Subject: RE: Radiology > > > Power ports are already being used for CT and MRI > > By the year 2010 all Vascular access devices will be > power injectable. It > will be a standard in the industry > > By the year 2010 heparin for central lines will no > longer be used. > Facilities will be heparin free > > But than I believe techs will be cross trained to do > vascular access > procedures as there will be no new nurses to end the > shortage > > Kathy > > > > > > > > Confidentiality Notice: This e-mail and any > attachments are intended only > for the use of those to whom it is addressed and may > contain information > that is confidential and prohibited from further > disclosure under law. If > you have received this e-mail in error, its review, > use, retention and/or > distribution is strictly prohibited. If you are not > the intended recipient, > please contact the sender by reply e-mail and > destroy all copies of the > original message and any attachments.[v1.0] > > > _____ > > > > > > From: [EMAIL PROTECTED] > [mailto:[EMAIL PROTECTED] > On Behalf Of Chris Cavanaugh > Sent: Tuesday, September 26, 2006 7:28 AM > To: 'Denise Macklin'; 'venous' > Subject: RE: Radiology > > > Denise, you are absolutely correct. My focus has > been MRI, not CT, however, > I would not be surprised that what I have found in > MRI departments mirrors > what you have seen. There are many MRI techs who > have no idea what a "power > PICC" is. There are departments who have no nursing > backup, techs only and > they have rules not to touch a central line. These > patients will always get > a PIV, or a butterfly just for the contrast, then it > is removed. Some > departments have radiology nurses who come into MRI > when needed. Rarely is > there an MRI with a dedicated nurse. When there is > a nurse, the contrast > injections, either by hand or power injectors can be > done through the > central line. The nurses do seem more knowledgeable > regarding Power PICCs, > in general, though some have never seen one. I am > sure the Power Ports will > never be used-too confusing for staff that do not > access ports now. Ports > are NEVER used for hand or power injection in the > MRI area. As far as > accessing the Power PICC, mostly I have seen the > connection through whatever > end cap is on the Power PICC. Rarely have I seen it > removed. I have never > seen them replaced. It is also very rare that the > saline flush of the power > injector is followed by a heparin flush, I have only > been in one MRI > department that had heparin flushes available. I > addressed these and some > other safety issues in my talk at AVA. > Chris Cavanaugh, CRNI > _____ > > From: [EMAIL PROTECTED] > [mailto:[EMAIL PROTECTED] > On Behalf Of Denise Macklin > Sent: Monday, September 25, 2006 11:39 PM > To: venous > Subject: Radiology > You may respond to me privately, but I bet many on > the list would be > interested. I have found in my travels that > radiology departments are doing > many different things when it comes to infusing > contrast into power piccs > for CT scans etc. Some infuse through the > connector, some take it off and > mainline, some change the connectors others do not. > If you would like to > share what procedure your radiology department is > currently using, I am > putting together some data on this topic. > === message truncated === __________________________________________________ Do You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com
