Changing dressing on Groshong

[cm8816]

Hello,

When changing a dressing (and cap) on a Groshong, if there is no "clip" to close the line to air, when one removes the old cap, isn't there a danger of air embolizm? Should one take a kelly clamp to the line before changing the cap, or will that damage the line?

[SoldierNurse22, BSN, RN]

Yes, there is danger of an air embolism. There isn't a clamp? Is it possible you can get another one? I personally wouldn't use a kelly on it, just in case.

[cm8816]

Thanks, that's what I thought.

[MunoRN, RN]

Most groshongs that you'll see these days are valved, so no clamp is necessary (supposedly).

[IVRUS, BSN, RN]

A Groshong IV catheter is VALVED, so as long as negative pressure with withdraw or positive pressure like infusing, isn't performed, the valve stays shut. Therefore, there is no worry about blood backing up or air embolism. It is extremely rare to have a malfunctioning valve.

It is important to know your catheters... And I hope this helps.

[cm8816]

Thank you for this information. I didn't know this.

[iluvivt, BSN, RN]

Yes! agree with IVRUS. This is a silicone catheter and should not be clamped because silicone is easier to fracture that other catheter materials currently being used. If a slide clamp or other type of clamp is not an integral part of the design of the catheter it has a valve as part of the design,which will either be in the distal end of the catheter or in the tails of the catheter.

The valves rarely fail but if you take a cap off and see blood freely dripping out of the catheter the valve has failed or is stuck open. I do not see this happen as much as I used to and many many years ago they readjusted the location of the three way slit valve on the groshong to stop this from happening. If a silicone catheter fractures on an external portion you can safely clamp it until it can repaired (or removed) by padding the clamp with 2x 2s or using a plastic one or a smooth one.

[Turn-my-cap]

OMG! A groshong has a one way valve at the end. DO NOT Clamp or use any scissors near a PICC!

Please go to the BARD website and learn about the product and how to care for the PICC.

They have a rep thatwould be more than willing to send info and maybe an inservice you need.

[SaoirseRN]

Is there a policy and procedure system where you work? Either online or paper format. It should tell you the specifics on protocols for the type of catheters you use. As others have stated, BARD groshong PICCs are valved and should never be clamped. Might also be worth contacting the education department if you have one for a bit more hands-on instruction.

[MunoRN, RN]

A Groshong IV catheter is VALVED, so as long as negative pressure with withdraw or positive pressure like infusing, isn't performed, the valve stays shut. Therefore, there is no worry about blood backing up or air embolism. It is extremely rare to have a malfunctioning valve.

It is important to know your catheters... And I hope this helps.

Sort of. A groshong "valve" can easily become just an opening, which makes it no longer a valve. The simple slit in the lumen that makes a groshong "valve" can easily get stuck in any of it's three positions due to the firbrin and thrombin that inevitably builds up particularly when used with a constant infusion which keeps the valve always "open", these edges of the opening are optimal for fibrin adhesion and can easily cause the valve to get stuck in the "open" position.

Solo groshongs have a true "valve" at the proximal end.

[IVRUS, BSN, RN]

Sort of. A groshong "valve" can easily become just an opening, which makes it no longer a valve. The simple slit in the lumen that makes a groshong "valve" can easily get stuck in any of it's three positions due to the firbrin and thrombin that inevitably builds up particularly when used with a constant infusion which keeps the valve always "open", these edges of the opening are optimal for fibrin adhesion and can easily cause the valve to get stuck in the "open" position.

Solo groshongs have a true "valve" at the proximal end.

A Solo Groshong??? Never heard of it. Now, A Solo Power PICC, yes, that has the Valve at its proximal end. However, because the distal end is open, these catheters are infamous for occlusions.

Again, though, having a Groshong valve "stuck" open is RARE.

[Anna Flaxis, BSN, RN]

For the purposes of the original question, Groshong PICCs are valved at the distal end, making clamping unnecessary. I do not clamp Groshongs for routine cap changes, and I flush with 10m before and after.

As to the side discussion, I treat Solo Power PICCs as if they are open ended, because essentially, they are. I flush with 10mL before and 20mL after.