Robbin,
Bard Access Systems Clinical Specialists and Territory Managers
are required to train all CT techs at a given facility before they can begin
using Bard's PowerPICC. The training focuses on the
following:
1. Recognizing the PICC as a power injectable PICC, by
virtue of it's purple color, the name PowerPICC on the bifurcation, and the
thumb clamps that indicate maximum flow rate and require them to check for
patency prior to power injection.
2. The maximum flow rate that can be used for power
injection of contrast media through a Bard PowerPICC,
5ml/sec.
3. The maximum pressure the power injector should be set at,
300 psi.
4. Warming of contrast media to body temperature prior to
power injection.
5. Checking the catheter for patency prior to power
injection of contrast media.
6. Removing the injection cap and connecting the power
injection tubing directly to the PICC for power
injection.
7. Flushing the catheter with saline following injection of
contrast media.
8. Applying a new, sterile injection
cap.
9. Instructing the nurse to lock the catheter with
heparinized saline, or to follow hospital protocol for catheter
lock.
There is also a wall poster that covers all of these points.
The poster can be ordered through Bard customer service. If you would like
one, please contact me directly.
Please let me know if you have additional questions.
Paul
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
Sent: Wednesday, September 27, 2006 3:47 PM
To: Blackburn, Paul; Nauman, Tanya; [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: RE: Power PICC questions
Was wondering what information was disseminated to the CT techs when the
Power PICC was promoted and inserviced by Clinical Specialist and Reps?
--
Robbin K. George RN
Vascular Access Resource
Alexandria Hospital Virginia
[EMAIL PROTECTED]
Robbin K. George RN
Vascular Access Resource
Alexandria Hospital Virginia
[EMAIL PROTECTED]
-------------- Original message --------------
From: "Blackburn, Paul" <[EMAIL PROTECTED]>
> 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 i f 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 sh ould 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
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> 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
>
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