Power injecting thru cental lines

Specialties Infusion

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IV nurses---

I have a very rambuncous MD who wants us to power inject (300 PSI) contrast media into cental veneous catheters. He says everyone is doing it. Is anyone out there doing this? If you are, do you have a protocol? Any information will be helpful at this point. I have contacted all the manufactures of our central lines and am not getting any clear cut answers.

Thanks!!!

Anne

Specializes in Critical Care, Emergency, Infusion.

AngioDynamics has a CT PICC called Morpheus (avail in 4 Fr SL and 5 Fr DL) with max CT flow rate 4cc/sec and max injection pressure of 300 PSI. The difference between the "purple power" PICCs and the Morpheus is that the purple PICC is stiffer the entire length of the PICC and the Morpheus is stiff in just the first 20 cm and then tapers into a nice, soft floppy PICC. The sales rep explained that with power injections, the 'power injection' puts the most pressure on the first few cms of the PICC increasing the risk of rupture, NOT on the tip of the PICC. What we do in a critical setting, is place a regular 5 Fr DL PICC in one arm, then trim a Morpheus to a midline length and place it in the other arm. When the critical period is over and freq CTs are not longer warranted, the we pull the MLC and still have our DL PICC.

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Specializes in picc certified.

This has become an issue here as well and the power picc is the only one that will say power injectors are o.k. All other manufactures specifically say no power injectors. Good luck

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There are several Central lines that can receive a power injection and the companies manufacturing these lines have done a great job of marketing this feature with color distinctions and labeling. Bard (Bardaccess.com) has a wonderful website showing pictures and descriptions of these lines.

Currently at our hospital, we use a Power Port & Power PICC. The power port can be identifed by a triangular shape (versus the more traditional round shape, and has three palpable points that can be felt when palapting.) Additionally, the power picc lines are purple in color and labeled very clearly- Power PICC.

Check out the Bard web site- great resource.

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Specializes in Infusion Nursing, Home Health Infusion.
IV nurses---

I have a very rambuncous MD who wants us to power inject (300 PSI) contrast media into cental veneous catheters. He says everyone is doing it. Is anyone out there doing this? If you are, do you have a protocol? Any information will be helpful at this point. I have contacted all the manufactures of our central lines and am not getting any clear cut answers.

Thanks!!!

Anne

ok here is the deal a cvc and that includes piccs must be manufactured as such it must state that it is safe to do so. for example bard has a triple lumen picc that we place and only the purple middle lumen can be used for a power injection at a max rate of 5ml per sec. they also have a new groshong picc 5fr that is also power injectable but its max rate is 4ml per sec. in order so you do not have to keep track of all the cvcs that do have this ability every manufacturer has it labeled on the tails of the line or if it an opened catheter it is usually in the clamp. if the catheter is not labeled as being labeled as such it cannot be used for that purpose. also remember that not every lumen may not have that enhanced capability. the other fairly new device on the market is the power port by bard. not only must this be identified as such......you must feel the heart-shaped design of the device ...it has a three point raised nub design......and then a special power injectable non-coring needle must be used.......best practice....if you cannot confirm that a device has this feature....you should not use it for that purpose....so the rad is getting a bit confused......permanentdamage can occur to the catheter and worse case scenario....... cath rupture and embolis hope this helps mary iv specialist x22 years

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