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Anthony Coddington
Are pressure injectables for everyone?

Does it make sense to place power piccs (pressure injectable) in everyone?  I feel there is a place and time for power injectables, but not everyone.  I have been in discussion with physicians that want power piccs in all ICU and oncology/sickle cell patients.  Does anyone else operate with "blanket" protocols covering entire populatioins?  Could anyone share research/articles about pressure injectables.  I would like to have supporting evidence for our next meeting.

Thanks in advance.

Anthony

nancymoureau
Hello Anthony, Consider

Hello Anthony,

Consider doing a cost analysis on regular PICCs, Power Injectable PICCs  (and actual usage) and on catheter exchange with a Power Injectable PICC if needed. You will need to correlate with CT to see which PICC patients are actually getting CT scans while inpatients. It may be cheaper to exchange the catheter if needed, on the other hand it depends on frequency of CTs at your institution. Good luck, my friend!

 Nancy Moureau

Nancy L. Moureau, BSN, CRNI, CPUI, VA-BC

PICC Excellence, Inc

 

DCrni
Why would a power injectable

Why would a power injectable picc need to be exchanged? Is it not just an open ended picc which has been specially adapted for power injection?  It's my understanding that the extention portion is really the only change in the catheter.

Just my 2 cents

 

Darilyn

Darilyn Cole, RN, CRNI, VA-BC
PICC Team Mercy General Hospital Sacramento, CA

 

kokotis
The cost of placing a short

The cost of placing a short peripehral IV is $32 (Santolucito/OHSU/JVAD 2000).

The cost of placing a power injectable PICC line with all materials, labor, x-ray etc for the hospital is $300 per patient on average.  The cost of a non power injectable is $275. 

In another two years we will not have this discussion as all manufacturer's will have a power injectable PICC line. 

Change now or wait two years but you will be changing to power injectable in all patients

If I am the patient I don't want to be stuck again for a power injection especially if the dye is the hypertonic kind that causes nerve injury or loss of a limb.  How do you actually know what patient will get a power injection in the future.  I have no idea. 

Does anyone disagree with me that all PICC lines used will be power injectable within two years?  It meets an unmet patient safety need.

 

Kathy Kokotis

Bard Access Systems

Darlene Kaminski
Anthony, At our

Anthony,

At our institution, we usually place power piccs in all abdominal diagnoses, for example Pancreatitis, Diverticlitis, Ruptured Appy's, etc....Most of these will require a few CT scans.  We did collaborate with our CT dept. to see what disease process required the most CT scans.  We also will place power piccs in the majority of our CA patients also.  I personally like to place them in the units  d/t instability of the patient and condition changes requiring more testing.  I always ask, is there a possibility of a CT?  If the patient is going home for routine abx therapy, I place a regular per-q-cath.  I just hate re-sticking patients for a ct scan or exchanging a PICC for a Power, when a power could have been placed the first time.  We don't miss many but there a those few. 

Good Luck

Darlene Kaminski

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