I know that our techs jump for joy when they see the color purple!
The BARD came out and did in servicing for these folks!  We have had no
problems at all.

Michelle Hansen, RN
Northeast Baptist PICC Nurse
office 297-2422
pager 235-9779

>>> "Chris Cavanaugh" <[EMAIL PROTECTED]> 9/27/2006 10:49 AM >>>
You are right, things do change, I am not disputing that fact at all. 
And I
realize power ports are only 2 months old, you are the one that said
they
are being used now..I am glad to see that the need for education is
being
addressed in CT, please do not forget the MRI departments also, as they
use
power injectors also.  The more education we can provide for the
radiology
RNs and the Rad Techs the better off our patients will be.  

 

Chris Cavanaugh, CRNI

  _____  

From: Kokotis, Kathy [mailto:[EMAIL PROTECTED] 
Sent: Wednesday, September 27, 2006 9:16 AM
To: Chris Cavanaugh; Denise Macklin; venous
Subject: RE: Radiology

 

Things change

The educational programs for power injection are just starting in CT
now as
we speak

Power injectable ports are only two months old

kathy 

 

 

 

  _____  

From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] 
On Behalf Of Chris Cavanaugh
Sent: Tuesday, September 26, 2006 7:43 PM
To: Kokotis, Kathy; 'Denise Macklin'; 'venous'
Subject: RE: Radiology

Kathy, I hope you are right, I would love to see heparin free VADs, if
the
research supports it.  I think decreasing infection risk is just as
important as preventing clotting.  And I hope all VADs will be power
injectable, but I think that will depend on the manufacturers making
them
less costly, so they can be used for every patient,  in the long run
it
would be safer for those patients in an acute care setting.  No need
for
homecare or LTC, were they are not used now.  As far as port being
used..well I have to disagree.  In the last year I have been in over
100 MRI
units, mostly in major university hospitals, some in smaller medical
centers
and some community settings.  I have NEVER seen a mediport used for
hand
injection of contrast.  In fact, I did not ask at all facilities, but
most
had a policy not to use the port and to have the patient sent to MRI
with it
DEACCESSED.  That way they did not have to worry about reinforcing the
needle in the scanner.  Perhaps it is different in CT.  But in MRI,
even
those that had radiology nurses who would come into MRI, the ports were
not
to be used.   Bard will have to keep this in mind as they sell their
port,
that MRI departments, and perhaps CT also, will need to look at their
policies for use of a mediport, and have RNs available to use them. 
This is
currently not in the scope of practice for most RTs.  I believe the
scope of
practice will change as the nursing shortage will force the issue.  
But
even so, it will be such a rare occurrence  and so many checks will
need to
be done -does it feel like a power inj port? Do we have the right
huber
needle? Do we get a blood return? Is the needle taped securely for
MRI?
That my guess is that most techs would just find it easier to start a
PIV
for the contrast.   

The overall feeling after talking to a lot of techs is that it is
easier to
just start a PIV then wait for a nurse to access a central line
now..they
hate to hold up a scan and this way they do not have to learn which
central
lines can be power inj and which cannot.  I am guessing they will feel
the
same about the ports.  

 

I wish it was different, but that is the CURRENT state.  Who knows what
2010
will bring?  I would like to see these great devices used to decrease
venipuncture on these patients, but we shall see...

 

Chris Cavanaugh, CRNI

  _____  

From: Kokotis, Kathy [mailto:[EMAIL PROTECTED] 
Sent: Tuesday, September 26, 2006 6:22 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

 

 

 

 

 

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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.  

 

Let me thank you for all your input in advance.  This is really an
interesting question

 

Denise Macklin



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