CT contrast via Port a cath Hmmmmm... IDK

Pediatric Critical Care Columnist · Apr 29, 2009

If the CT is just a "normal" CT with contrast, it should be fine. That sort of application is one reason for placing them in the first place. BUT... Contrast for a CT-angio has to be pushed at a rate of at least 5 mL per second at 300 psi. I'm not sure a Broviac would take that type of volume/pressure without the tip being damaged since Bard doesn't recommend any infusion pressure greater than 25 psi, but Power Ports (both implanted and PICC) are capable of handling that kind of volume and pressure.

Smith-Lee · Apr 29, 2009

I agree if they need it for pressure infusion be very careful with pressure injector Depending on the procedure if they just need to see contrast would work great. GOOD THINKING ABOVE entries...

Have them check port type and how much pressure to infuse with cath hotline for question.

iluvivt, BSN, RN · May 2, 2009

It must be a Power Port and MUST also be accessed with a special non-coring needle that is also capable of tolerating the high pressure...if it is BARds product this is the purple power port and must be accessed with a power injectable right angle non-coring needle....we use a power loc by Bard...but they also make what is called a safestep that is power injectable...make sure it is.b/c safestep also comes as a regualr non-coring as well.....here is what you need to do...you must have at least 2 of the 4 identifiers before you use the port and I will tell you what those are...and you MUST absolutely get a BLOOD return and Power injection through a CVC must be done by RN or MD (techs can do the PIVS though)

Here are the identifiers....must have 2 of 4

1 must feel the palpation points on the septum

2 must ID the triangular shape

3 power port device pt ID card

4 power port device med record

YOU must follow the manufactures IFUS (instructions for use) to the letter as several are now coming out with all types of power injectable CVCs...hope this helps

jwhart · May 30, 2009

Hello all....

We're trying to see if we can move in the direction of having CT Techs handle and inject through PICCs. I noticed a comment stating that only RNs and MDs can do this. This is also the current policy in our facility.

Is there any documentation out there that specifically prohibits techs from taking on this task after proper training? Thanks for any responses.

Smith-Lee · May 30, 2009

I am an RT and my license allows me to do any procedure that I have been trained in. Many years ago there were not any RNs assigned to the Radiology Department. As long as the Tech is adequately trained and knows the limitations of the PICC line and how to make sure that it is a useable line.

If there are questions that you have you could contact ARRT American Registry of Radiologic Technologists.

I was at a conference a couple of years ago and there was a speaker there that was an RT and an Attorney at Law and she spoke of the broad scope of practice of the RT.

Smith-Lee

jer_sd · May 31, 2009

Hello all....
We're trying to see if we can move in the direction of having CT Techs handle and inject through PICCs. I noticed a comment stating that only RNs and MDs can do this. This is also the current policy in our facility.
Is there any documentation out there that specifically prohibits techs from taking on this task after proper training? Thanks for any responses.

Are rad techs regulted in your state, if so check with the licensing board for them. For example in California a rad tech can only start IVs and/or inject contrast in the upper extremity. So this could be interpreted so say PICC ok, chest port not ok.

When I access a power port since there are multiple ones on the parket. I ask to see the patient card, or have the op report from placement. Then I ensure that the flow rate and PSI are within guidlines, and these have some variability based upon needle size you acess the port with.

Jeremy