One of my colleagues recently brought me some information about different syringe sizes having different pressures and the need to use a 5 or 10ml syringe when instilling Alteplase into a vascular access port. Is this accurate? Does this concern about syringe pressure carry over to injecting medications thru a running IV into a port? Can you refer me to more information about this topic? Thanks Suzie
Syringe size is one factor that may lead to an increasing intraluminal pressure and thus cause catheter rupture in the form of linear slits on the catheter wall. Generally speaking smaller syringes generate greater pressure on injection. This is why all catheter instructions for use have some specific statements about avoiding excessive pressure. The issue is the amount of force applied to the syringe plunger (an unknown quantity) meeting resistance within the fluid pathway (inside the catheter lumen or around the catheter tip in the blood vessel). When this force meets resistance, increasing intraluminal pressure results. You can read a lot more about this in:
1. Macklin D. What's physics go to do with it? Journal of Vascular Access Devices. 1999;4(2):7-13.
2. Hadaway LC. Thrombotic and Nonthrombotic Complications: Loss of Patency. Journal of Intravenous Nursing. 1998;21(5S):S143-S160.
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