RE: Malposition after power injection

[Dianne Sim]

I wouldn’t think so. You have gravity working in your favor when you are attempting to flush the tip out of the IJ. Also from what I understand, the composition and dimensions of the Power PICC catheter body is the same as the Poly Per-Q-Cath (it was beefed up in the hardware of the hub, Y-section and extensions to cope with the pressure of the speed injectors) so should respond to that procedure in the same way as a Poly Per-Q-Cath. Regards,   Dianne Sim RN CEO & President     IV Assist, Inc., 2675 Appian Way Pinole, CA  94564 Phone: (510) 222-8403 Fax: (510) 222-8277 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] From: owner-venous@mailsrv1.ohsu.edu [mailto:owner-venous@mailsrv1.ohsu.edu] On Behalf Of Roger Soriano Sent: Thursday, October 12, 2006 7:21 PM To: Blackburn, Paul Cc: [EMAIL PROTECTED]; Nadine Nakazawa; [EMAIL PROTECTED]; [EMAIL PROTECTED]; Kokotis, Kathy Subject: Re: Malposition after power injection   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]            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 [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 CONFIDENTIALITY NOTICE: This e-mail message, including all attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. If you are not the intended recipient, you may NOT use, disclose, copy or disseminate this information. Please contact the sender by reply e-mail immediately and destroy all copies of the original message including all attachments. Your cooperation is greatly appreciated.