Re: Malposition after power injection

[Roger Soriano]

So does this mean that the POWER PICC is not easily flipped when it is inadvertently placed in the IJ??

On 10/12/06, Blackburn, Paul < [EMAIL PROTECTED]> wrote:

Susan, Nadine, Dennis, et al

 

The Bard PowerPICC was designed and tested to ensure that the catheter tip does not whip about during power injection of contrast media.  The catheter in fact may back up slightly (about 1cm), but does not whip about in the SVC during injection.  The testing was done in a model that simulates normal human body temperature, blood flow and pressures.  The contrast media that was used for the testing was the most viscous product available on the market.  The testing was conducted on many catheters over the course of several days.  In other words, the catheter was in place in this simulated human environment for nearly two weeks, with power injection of contrast media taking place daily.  So in reality the testing simulated conditions that would be found in the patient care environment, outside of the fact that very few patients would recieve power injection of contrast media on a daily basis.  With that being said, we did not see the catheter soften or flex enough to flip into another vessel--unless the catheter was not properly situated in the first place.  In other words, if the catheter tip is located any where from the lower 1/3 of the SVC to the Caval/Atrial junction, it does not leave the SVC even with repeated power injections over the course of serveral days.  To that end, I don't believe the Bard PowerPICC will malposition merely because of the injection of contrast media. 

 

Hope this helps to explain things a little.  Please let me know if you have additional questions or need more detail.  Paul

 

Paul L. Blackburn, RN, MNA

Manager, Clinical Education

Office:  800-443-5505, ext. 4981

Mobile:  801-598-1657

Email:  [EMAIL PROTECTED] 

 

 

 

 

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From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]] On Behalf Of [EMAIL PROTECTED]
Sent: Thursday, October 12, 2006 11:20 AM
To: Nadine Nakazawa; [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: RE: Malposition after power injection

Makes me wonder if this is something that was considered and or studied by any of the manufacturers.

Paul????Are you reading?

 

 

--
Susan Schuetrumpf, CRNI
VASPRO
Atlanta, GA
cell-404-606-1194

 

-------------- Original message --------------
From: "Nadine Nakazawa" <[EMAIL PROTECTED]>

>
> I was wondering that once power PICCs have been out for awhile if we would
> see this phenomenon occur ---secondary malposition because of all the
> whipping around. How deep to you place your original PICCs?
>
> Nadine Nakazawa
>
>
>
>
> >From: "DAVID LONGSETH"
> >To: [EMAIL PROTECTED]
> >Subject: Malposition after power injection
> >Date: Wed, 11 Oct 2006 20:05:42 -0500
> >
> >Saw a set of CXR's last week that were of interest. Pt had a 5Fr Power PICC
> >placed in the AM,then a CT in the afternoon (chest for PE,I think). Later
> >in the evening pt. began having discomfort and swelling in the neck. CXR
> >af ter PICC placed showed a good lower SVC placement but the evening's film
> >showed the line up the IJ,perhaps with the tip in smaller collateral vein.
> >Apparently the CT contrast injection was strong enough to flip the PICC up
> >there.
> >Was wondering if anyone else has seen this occur,but then also wonder if
> >this doesn't happen more frequently and we just never know....
> >David
> >
> >
> >
>
>
>

--
Roger Soriano, RN
Vascular Access Specialists
818-687-8348

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