I received two conflicting advice regarding the use of power injectable non-tunneled catheter. The catheter company states that power injectable non-tunneled CVC is safe for power injection. However, our IV expert states that non-tunneled CVC must not be used for power injection - especially if it is placed in IJ. Which advice is correct?
If the catheter inside the patient has power injection included in the IFU for that product, then that catheter can be used for power injection. Does the IFU also include IJ placement of this catheter? If yes, then it can be used for power injection. The tip location of the IJ should be confirmed with a scout scan before power injection, jsut like any other CVAD. I think your IV expert does not understand the advances in this technology and is relying on old information, but I would ask her why she thinks this.
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Office Phone 770-358-7861
Thank you I will do so.
here is the deal with power injection in CT ,if they will do regular contrast injection it is not an issue if the power-PICC not less than 30 cm (or if the jugular line is power injection catheter) or in some cases 4 Fr vascular sheath.
in CT scan usually they use any power-PICC of central line without issue even for lower limb CT-angiogram where it is considered high-rate injection (3-4ml/sec) and high volume of contrast. pressure can reach 200 PSI.
in some cases where the CT do not need a high-rate injection, we put 4Fr micropuncture sheath or 4 Fr vascular sheath if they just need the access for the scan and they could not insert 18g angiocath.
if there is a tip issue ( not in SVC or few cm away from an occlusion ) it might be a reason not to use the catheter.
the chest scout quality and radiation dose is greater than regular chest Xray. However, if the CT scan for the chest we use the scout to confirm the tip before injection. If the CT for bran for example, we prefer to do regular chest Xray instead because of the radiation dose.
One thing or one principle in such cases” there is no black and white, write or wrong” each case has different circumstances.
Johns Hopkins aramco Healthcare