Several years ago there was an photo essay in the AVA journal about the tools used to trim catheters
The pictures were very telling--Scissors v Scalpel v Guillotine
I would like to revisit the discussion and survey the vascular access community on the subject
What type of tool are you using the cut your PICC and who is supplying the product to you?
Thank you in advance for your responses
Robbin George RN Vascular Access Resource Dept Alexandria Hospital Virginia
Janet Petit did an extensive review of all the cutting tools and complications rate in JVAD
I suggest a review of that great article
Kathy Kokotis
Bard Access
Dear Kathy--I know about the article as I stated in my original Question--But I want to know what type of trimming tools are being used in the Vascular Access community and get some feed back from the PICC inserters among us
Just as an example would be my comment that the scissors currently found in the BARD SOLO PICC kit make a very unsmooth cut [Sort of like cutting with those safety scissors we had in kindergarten]
So others out there please comment on this clinical practice issue
Robbin George RN VA-BC
I don't know the correct English term, but we use the kind of knife that you use to pick sutures away when they are no more needed. We just fold the catheter over the sharp part of the knife and cut upwards. As far as I can see, it gives a straight and cleen cut. This is for cutting off excess catheter from Groshongs. I think that most groshong PICCs are cut this way in Sweden. It works well.
Mats in Stockholm
Hi Mats, I think you are talking about trimming the external end of a Groshong single lumen catheter. That is very different from trimming the internal end of a catheter, the end that will be in the bloodstream. Any device designed to remove sutures is not a sharp enough device to create a smooth cut on this internal end of the catheter. Scissors have been found to produce the roughest cut while a scalpel blade produces the cleanest cut. But cutting at the bedside always carries the risk of creating a jagged edge or loose pieces that can easily promote the growth of thrombosis. That is what the Pettit article demonstrated by taking pictures of these trimmed catheters through a high-powered microscope. Some catheters are packaged with their own trimming tool. Many years ago, Ron Luther from Luther Medical conducted some tests to show these rough cuts and created such a tool to allow a smooth even catheter tip. I think this is still available with the BD catheters, but I have not seen it in a while. 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