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afruitloop
Power Groshong vs. Solo

Could someone elaborate on why a nurse would pick a power grohong over a power solo or vice versa?  I understand the differences between the two devices, but wonder how those differences should be considered for insertion practice.

Thanks

sesymons
The advantage of the Solo
The advantage of the Solo over the power groshong is that you can trim the tip so that there is not extra length of catheter coming out of the insertion site. This would then decrease the chance of dislodgement and risk of infection.
nancymoureau
These days with dual lumen

These days with dual lumen catheters being the norm trimming is easier on the distal end, if it is even necessary. I think it is much better to get the average length that you use for upper arm placement, say 40cm and keep them in stock with a few 50cm lengths also. 

I am a bit concerned about using a Groshong or any silicone catheter for power injection.

Nancy L. Moureau, BSN, CRNIPICC Excellence, Inc

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

PICC Excellence, Inc

 

windstrings
But then the "disadvantage"

But then the "disadvantage" is being clean cut at the end affords future issues with catheter draw being more likely to be positional.

 

The main thing I like about groshongs is that the end is blunt and the holes are actually on the sides near the tip.

if the tip jamms into a surface, the holes are less likely to be affected. So if this issue is really an issue, the power groshong would be more desirable.

 

I don't see why they couldn't give us a tool that after cutting a solo end, we could stick the tip in a little clamp that would punch non coreing holes near the end... this way you would have a hole in the end "and" on the side near the tip.... increasing blood blow potential and affording another area for flow to go should the hole in the very end become plugged or becomes jammed into a fleshy surface to plug it causing a "can push but can't pull" scenario.

All in all, I expect the solo to be better for the patient "if" it really works as advertised.

However, there are a few installation tricks to verify tip placement that the valves in the solo prevents..... "but so does the regular groshong for that matter"..... only using a nonvalved open ended catheter allows such confirmation.

The second mouse gets the cheese!

lynncrni
What you are suggesting

What you are suggesting would be an engineering nightmare, along with so many problems that I would not even wish to go there. Cutting a catheter to length has numerous questions. Years ago, Luther Medical documented that cutting produces jagged edges on a PICC and they created a special tool for cutting their catheters. More recently Janice Pettit published a study about jagged edges she found on neonatal PICCs. Then add the numerous questions about proper flushing and fluid overflow from these side holes. 

The facts are that the Groshong valve lies in the bloodstream and can have the same amount of fibrin that any open catheter tip can have.

The valves on PASV and Solo are in the hub, outside of the bloodstream, so not going to have the same issues with fibrin.  

 

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

www.hadawayassociates.com

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

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