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 RETIRED Cath Lab/Cardiology/Radiology.

After much discussion between Rads and Techs and RNs, (and having contacted mfrs of central venous access devices), our policy is we may use power injector for central venous lines ("triple lumens") only after consulting w/Rad, and on his order, at no more than 1.5cc/sec. NO power injections thru PICCs, Hickmans, Portacaths, etc. May hand-inject Hickmans/Portacaths if contrast needed. We only use Omnipaque-300. Best, -- Diana

Specializes in Med/Surg, ICU, Cardiac ICU.

I have no direct experience with the injectors, just the results of the blown lines on the patients. Thankfully none that did worse than severe bruising but this is extremely bothersome as the reason some of these patients have lines other than peripheral is that they have no easy to access veins.

As nurses we had approached Radiology as to why and now are seeing more that use hand-injection here.

We're not doing it. Look at the literature from the catheter manufacturer. What are the psi limits? At our facility, we do not power inject anything. If the patient needs contrast the IV team is called and we hand push it. If they need a PE study, they must have an 18 g periperal site inserted or the test is not done.

We use the Per Q Cath by Bard and it states not to exceed 40psi.

bard now has approved "power piccs" which allow for very rapid infusion on contrast, 5cc/second.

Specializes in Oncology/Haemetology/HIV.

The new purple "Power PICCS" are the only CLs that I know of where it is safe to use the power injectors.

Most facilities do not have the Piccs that will take the pressure, so it is better to stay on the safe side.

Specializes in Everything.

Hi Anne

Simple, with MD's who demand the use of power injection for contrast agents via CVL's should simply do that themselves. Here that task is the responsibility of the radiology department and the MD (consultant) performs that task. Not keen on 'Power PICC' for this task

Specializes in Palliative Care, NICU/NNP.
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.

We do not power infuse through a PICC unless it is a power PICC especially designed for this purpose. I doubt "everyone" is doing this for fear of rupturing the line.

We use the Bard purple power piccs exclusivley now and they are used routinely for power injections. Arrow is also coming out with a power picc very soon that we will be trialing. He's only being rambunctious if he is not using piccs designed for this use.

We use Bard purple Power. It is sort of the unwritten standard that out CCU patients get power piccs. Pretty soon that's the majority of our Piccs will be power piccs. Our radiology dept has looked at a Power Portacath that you can power inject with. It is suppose to be shaped like a heart so when you palpate the area you can tell the patient has a power portacath.

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