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Christine Thomas
Removal of PIV after CT contrast injection
I have read in several list serve comments that some hospitals have a policy to remove the IV Catheter after contrast injections due to the irritation of the vein and possible subsequent phlebitis or DVT especially if the IV is in the antecubital.  Do any of you have this policy.   We started doing this approximately 4 years ago and did see a vast decrease in upper extremity DVT's.
lynncrni
This is a wonderful policy!!

This is a wonderful policy!! Congratulations on getting it approved. Sure wish you would publish your experience. 

 

Lynn Hadaway, M.Ed., RN, BC, CRNI

www.hadawayassociates.com

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

kokotis
Kathy Kokotis Bard Access

Kathy Kokotis

Bard Access Systems

Quite a few of the contrast injections have osmolarities over 500 mOSM/L thereby irritating the vein.   A number of them are also vesicants.  The guidelines state that after the administration of a vesicant which many of them are one cannot use the line for continuous infusions of any other med.  Even if it were not continuous the idea of removing a line that had a vesicant after its administraiton is a good idea.

Kathy 

 

Kathy Kokotis

Bard Access Systems

kokotis
Kathy Kokotis Bard Access

Kathy Kokotis

Bard Access Systems

ONS Guidelines which Lynn said have put out new ones in 2009.  They have alot on handling vesicant administrations and many of these contrast agents are vesicants.  The guidelines are for sale on ONS website

Kathy 

 

Kathy Kokotis

Bard Access Systems

Donna Fritz
Kathy, would you reference

Kathy, would you reference your comment?  I have not read the entire 2009 ONS Chemo/Bio Guidelines, but I have looked at IV administration.  ONS seems more focused on the "before" of vesicant administration than the "after" of a successful administration.  The only three comments I could find pertaining to vesicant administration "after" care (not including extravasation) are on pg 102.  Referring to a "short infusion", it says "Once the short infusion is complete, check vein patency and flush the line with a compatible IV solution."  Referring to IV push using side port, "Once the IV push is completed, check vein patency and flush the line with a compatible IV solution."  The direct push method (not using side port of IV fluid tubing), "Cap or discontinue the IV access, as indicated."  None of them mention discontinuing except the last one, and that gives you a choice.  I'm not saying that DC'ing PIVs after contrast isn't a good idea--just not sure anything ONS has in these guidelines provides support for it.

 

kokotis
Kathy Kokotis Bard Access

Kathy Kokotis

Bard Access Systems

Donna that is the best you are going to find in a guideline.  To my knowledge there is no INS standard that says it must be removed.  Does anyone know if Royal College guidelines made any statements regarding removal of PIV after contrast?

Kathy 

 

Kathy Kokotis

Bard Access Systems

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