The American College of Radiology as well as a few manufacturers of IV devices recommend hub to hub connection of a power injector for contrast to a peripheral IV (or other power injectable catheter). Any add on devices, including end caps, can impact the pressure of the injection, cause a restriction and decrease of flow rates, and allow for leakage of contrast. I do not know of any contrast manufacturers that recommend thier contrast be administered filtered, either.
I do not see anything in this manual that recommends hub to hub connection though. As the FDA has stated in numerous communications, all devices used for power injection must have a manufacturer's approval for power injection use and maximum psi (usually 300psi or greater is need for power injection purposes) and I do not know of any filters that have that approval.
I'm still looking at PIV manufacturer's recommendation for direct connection (power injection tubing to hub of catheter) and haven't found that recommendation yet.
The issue driving hub to hub connection is the pressure rating of the needleless connector. Some can tolerate 300 psi but some can not. Also, don't forget to assess pressure tolerance of the extension set connected to the catheter. Lynn
The American College of Radiology as well as a few manufacturers of IV devices recommend hub to hub connection of a power injector for contrast to a peripheral IV (or other power injectable catheter). Any add on devices, including end caps, can impact the pressure of the injection, cause a restriction and decrease of flow rates, and allow for leakage of contrast. I do not know of any contrast manufacturers that recommend thier contrast be administered filtered, either.
Chris Cavanaugh, RN, BSN, CRNI, VA-BC
Agree with Chris!!! for what purpose do you think you need a filter?
The American College of Radiology Contrast Manual Version 7 is a great resource and it is available at no cost at:
http://www.acr.org/secondarymainmenucategories/quality_safety/contrast_manual.aspx
I do not see anything in this manual that recommends hub to hub connection though. As the FDA has stated in numerous communications, all devices used for power injection must have a manufacturer's approval for power injection use and maximum psi (usually 300psi or greater is need for power injection purposes) and I do not know of any filters that have that approval.
I'm still looking at PIV manufacturer's recommendation for direct connection (power injection tubing to hub of catheter) and haven't found that recommendation yet.
Paula McMahon, RN, CRNI, CRN
The issue driving hub to hub connection is the pressure rating of the needleless connector. Some can tolerate 300 psi but some can not. Also, don't forget to assess pressure tolerance of the extension set connected to the catheter. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861