Tanya, I will answer your questions from the manufacturer's standpoint:
1. Does the contrast injection occurring in the SVC rather than the periphery change the timing or decrease the clearness of the CT image? Yes injecting contrast media into the SVC will change the timing to some degree as the contrast does not have to travel through the periphery and then into the SVC for distribution to the target organ. Injecting contrast media into the SVC versus the periphery has been reported to improve clarity rather than making the image less clear. This is due to the fact that the target organ receives a bolus of the contrast media in a more concentrated dose than it would if the contrast media were infused from the periphery. 2. Power injection through needleless injection caps: Please refer to the PowerPICC Instructions For Use (IFU). The IFU instructs the CT technologist to "remove the injection/needleless cap from the PowerPICC catheter" before power injection of contrast media. As most needleless injection caps are not approved by the FDA for injection of contrast media, you are risking damage to the injection cap, and lower flow rates of contrast media than expected if you inject contrast media through a needleless cap. 3. Can these catheters be flushed and locked with saline only? Heparin induced thrombocytopenia is certainly a matter of concern, however, the PowerPICC has been designed to be locked with heparinized saline. If you add a positive pressure needleless access device to the PowerPICC, you should follow the needleless access device manufacturer's recommendations for locking the catheter with their device. There are many facilities throughout the US that are heparin free and therefore lock their PICCs with saline only, based on recommendations from the needleless access device manufacturer. Please let me know if I can provide you with additional information. Paul Paul L. Blackburn, RN, MNA Manager, Clinical Education Office: 800-443-5505, ext. 4981 Mobile: 801-598-1657 Email: [EMAIL PROTECTED] 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] -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Nauman, Tanya Sent: Wednesday, September 27, 2006 10:38 AM To: [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: Power PICC questions We're starting to place Power PICCs on Oct 2. Two questions have arisen: >From CT techs: Does the contrast injection occurring in the SVC rather than the periphery change the timing or decrease the clearness of the CT image? Also, our techs have been injecting through the MaxPlus cap of the peripheral lines and don't want to remove and replace a cap--What are they doing about this in your CT departments? >From docs: Can these catheters be flushed and locked with saline only? Many of them are very concerned with Heparin-induced thrombocytopenia and may write specific orders for Groshong PICC's just to avoid the use of Heparin. Thanks for any input. Tanya R.N. SHMC Eugene, OR ___________________________________________________________ This message is intended solely for the use of the individual and entity to whom it is addressed, and may contain information that is privileged, confidential, and exempt from disclosure under applicable state and federal laws. If you are not the addressee, or are not authorized to receive for the intended addressee, you are hereby notified that you may not use, copy, distribute, or disclose to anyone this message or the information contained herein. If you have received this message in error, immediately advise the sender by reply email and destroy this message.
