This week I found a patient with a 'Power Line' in place. This is a patient who had an inappropriate request for PICC placement and was sent to interventional radiology for a Hohn. It was time for discharge to a swing bed so I took a look at her 'Hohn' and found out what she had was something different.
According to the interventionalist we've had the Power Line in-house for a long time, but somehow that has escaped me.
I have the package insert and it helped me a lot (I need to write a policy for care and removal) but I can't find anything about dwell time. The rad says it can stay in indefinitely (as long as it's needed, anyhow) just the same as any tunneled catheter. I'd like to have more than just the word of the interventionalist on this but I can't find it on the insert.
I'm also somewhat skeptical about sending these patients out of the house with the line in place when it is likely there's nobody on the other end (small hospital) who is familiar with the removal process. The rad says, 'They come out easy just like any other central line' but that isn't reflected in the package insert where it discusses the possiblity that the cuff may enmesh in the sub-q tissue and require dissection. Since we send patients to facilities where often there is no surgeon....perhaps nothing more than a mid-level nurse or PA.......I'm a little uncomfortable with turning these patients loose with a Power line in place.
So my questions are...... What is the dwell time on the Power Line, and have you ever required assistance when you removed one of these?
Alma Kooistra CRNI