Quote from rnin02
i thought that they could use a central line, but to do so they would have to do the contrast slower and change some of the settings on the machine to get accurate results...so they don't like to do it. but it is possible. but i could be wrong and thinking of something else.
iv contrast for non-vascular studies usually can be done this way.
however, if they are trying to visualize arteries (ct angio of head -- or anything else -- ct chest r/o pe), then the contrast has to go at a certain speed, otherwise the test will be non-diagnostic. usually, we referr to these kinds of cts as needing a "power injector." iv contrast for ct abdomen, ct chest non-vascular, etc can be done with hand-injected contrast, or machine-injected with settings adjusted; and can be given through any picc or central line, as long as your facility allows it.
the problems with using a traditional central line and using piccs for tests requiring a power injector are different.
traditional central lines are fairly stiff, but strong. when the contrast is injected through them, it can cause the tip to whip around, possibly damaging the (major) vessels. traditional piccs are soft, but not very strong. the problem here is the very real possibility that the power injector will cause the picc to fracture. (think about it -- if you can't use anything smaller than a 5 or 10 cc syringe [depending on your facility policy] because it may cause the thing to break, what do you think thick contrast injected under high pressure would do?)
bard solved that problem by creating a power picc: strong enough to withstand the power injector, yet still soft enough to not damage vessels. better yet, they actually studied how the power picc reacted to a pressure injector, and found it safe.
i could be very wrong about this, but my understanding isn't that it is unsafe
to use a (non-picc) central line for power-injected constrast, but that nobody has proven that it is safe.
i believe that the concern that the tip of a tlc could cause damage to the vessel walls is a concern, a theory, more than fact.
that being said, i know
that you will find that some facilities use subclavians/ijs with the power injector -- i've worked in one of them.:uhoh21:
i'm not sure, though, why one poster stated that they can't use piccs/central lines for nuc med studies. that is hand-injected, not power injected, and i've never worked anywhere that had that limitation.