for anyone inserting/ using Power PICCs
Do you have patient criteria for selection to place a Power PICC
What is it?
Do you place power PICCs for home or LTC patients?
Under what circumstances
What is you flushing protocol?  solution?  Frequency
Are you seeing any occlusion issues/ problems with these catherters?
Please describe
What are your doing about problems? Â
Thanks  Ann Zonderman
We have a rather loose patient criteria......we use power PICCs in patients who are critically ill, new admits with abdominal diagnoses that are likely going to need CT scan and possibly TPN, actually most people with gut issues who are still in the diagnostic phase of hospital stay. We started using them around 6 months ago and are using them more frequently than I thought we would. The staff love them.
I can't imagine placing for home or LTC use unless the patient was long term on TPN. I think it's too much catheter for basic antibiotic, etc infusion outside of the hospital. I feel that way about all dual lumen catheters.
Home or LTC our PICCs are often flushed only daily at the time of infustion. This seems to work well (we use an open-ended PICC).
We're not seeing problems with these lines at all.
Alma Kooistra RN, CRNI
Early on we tried to develop guidelines for the use of Power PICCs, but the results were unsatisfying. We had a patient admitted with osteomyelitis of the toe for long term IV antibiotics, so no expectation of a diagnostic workup. He got a Groshong. Two days later the guy starts complaining of chest pain, so now they want to do a CT angio study of his lungs to rule out a pulmonary embolus and all he has is a Groshong PICC. This type of thing happened several times.
Once BARD replaced the 6 French Power PICC with the 5 French Power PICC, the main advantage of placing the Groshong was gone, at least in our setting. We have had no increase in the incidence of plugged lines or thrombosis with the Power PICCs. They are much more durable and versatile. If the patient lands in the ICU, the line can be used to monitor CVP.
We have gone to the Power PICC for more than 90% of our lines. We still keep a few Groshongs around for the rare Chemo outpatient who does not get an implanted port, and our Hospice patients who only require a small single lumen line, but next month BARD is coming out with a single lumen 4 Fench Power PICC, and that will probably replace the single lumen Groshong we now use.
Jerry Bartholomew RN, BSN, CRNI
VA Medical Center, Spokane, WA
Jerry Bartholomew RN, MSN, CRNI
VA Medical Center, Spokane, WA
Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center
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
The Power Groshong,when available,should prove very popular!
D
It is almost impossible to predict the future so I would look to providing the same standard of care and device type to all patients.
Power injectable vascular access devices of all kinds will become the standard of care not the exception soon. In all vascular access devices.
Kathy Kokotis
Bard Access Systems
Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center