Power injecting thru cental lines - page 2

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... Read More

  1. by   kathys76
    I also need some help in this area. Bard came out with the PowerPort in July of this year. Not a great deal of info out there to let you know if these are all they're "advertised" to be! I have in writing that there were no clinical trials.....only FDA testing with 36 repeats of performance. Has anyone had any experience with these? Any problems so far?
    Last edit by kathys76 on Oct 2, '06
  2. by   PICC ACE
    first a few specifics from someone at bard--this was posted on another site:
    bard access systems clinical specialists and territory managers are required to train all ct techs at a given facility before they can begin using bard's powerpicc. the training focuses on the following:

    1. recognizing the picc as a power injectable picc, by virtue of it's purple color, the name powerpicc on the bifurcation, and the thumb clamps that indicate maximum flow rate and require them to check for patency prior to power injection.
    2. the maximum flow rate that can be used for power injection of contrast media through a bard powerpicc, 5ml/sec.
    3. the maximum pressure the power injector should be set at, 300 psi.
    4. warming of contrast media to body temperature prior to power injection.
    5. checking the catheter for patency prior to power injection of contrast media.
    6. removing the injection cap and connecting the power injection tubing directly to the picc for power injection.
    7. flushing the catheter with saline following injection of contrast media.
    8. applying a new, sterile injection cap.
    9. instructing the nurse to lock the catheter with heparinized saline, or to follow hospital protocol for catheter lock.

    there is also a wall poster that covers all of these points. the poster can be ordered through bard customer service.

    me again: one thing to note is the direct connection to the hub--i don't think that any of the injection caps on the market are approved for power injection but there may be one or two.
  3. by   kathys76
    Thanks for the info . We've used some of the PICCs and haven't had any problems so far. My concern is with the new port-a-cath. Since it's only been available since July and there's no clinical trial data.....I'd like to know if anyone's had any problems or are they working well?
    Also, before you connect a port to power injector for the first time, should a scout film be done to ensure there's no possibility of pinch-off?
    I know I have more questions than normal.....but I'm not getting any information from my rep. Which makes me concerned about why they're not being more 'up front'.
    I appreciate the help if you know...........
  4. by   nursebuxom
    in my facility, the purple power piccs only.
  5. by   augigi

    Haven't used it so can't help there, sorry. FDA decided it was technically similar enough to currently available devices and therefore did not require premarket trials.
    Last edit by augigi on Oct 10, '06
  6. by   kathys76
    Thank you very much for the help and info from PICC ACE and AUGIGI! Got a meeting the Standards Committee this week and I think we're going to start using these ports by next week.
    I'll let you know how things go.....
    All we can do now is hope these are all what Bard says they're suppose to be!
  7. by   augigi
    You're very welcome. You can check for device complications on the FDA database (there are none for PowerPort so far) here: http://www.accessdata.fda.gov/script...UDE/search.cfm
  8. by   obie
    as far as i know you can only power inject on power piccs or ports that could withstand pressure up to 300 psi
  9. by   dauschundlover
    I think maybe the doctor involved may have his info confused. Bard does have a PICC, the POWER PICC, which allows for rapid injection for dye studies. I believe the rate is 5cc per second, you can always go to the Bard site and get the particulars. Other then that I've never heard of power injecting through central lines.enguin:
  10. by   IR-Champ
    We've been taking out the "Power Ports" like crazy. Those little nubs on the septum has been causing additional irritation and the size puts extra pressure on the skin. So, the ports are eroding through the skin. And that "triangle shape", B Braun's ports are ALL that shape. And, B Braun ports are not power injectable. Half the nurses refuse to access for CT now because of this stuff. What's the point for twice the cost?!? Very frustrated.
  11. by   loudog63
    there's a new product called the "Purple Power" port and PICC, that is manufctured to tolerate incr PSI used with CT injections. I know the port is TRIANGLE shaped, to distinguish it for any practitioner. What I don't have avail is the mfg name. -Hope this helps. -Karin Leppanen, BSN OCN, Director of Outpt Clinics, Anna Jaques Hospital
  12. by   st4304
    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.
  13. by   BigDog
    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