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mary ann ferrannini
POWER Injection through a catheter rated for power injection

 As long as a PICC/CVC is rated for power injection my understanding is that it can be used safely per the IFU's for that product. Of course, it should be checked for tip placement with a scout scan or a very recent CXR and a brisk blood return should be obtained..the tech or RN should determine the ml/per sec max and not inject higher than that rate...For example, the Bard power PICC is a max of 5 ml per sec and is clearly labeled on the catheter tails. Now I have been getting some questions from the radidology RNs and somehow they are under thre impression that they have to inject slower than the manufacturer says...they are concerned about damage to the vessel. Now I know catheters can whip around but I thought you can inject up to the max if needed...I know most of our techs can get good pictures with a 2-4 ml per second and tend to go to the higher rate rate with the chest or if they are not getting good pictures ....I know the rapid blood flow pretty much keeps that catheter down but I am certain it can malposition the catheter...I suspected this one time with a 5 Fr Bard power PICC . is the burse pressure always higher than the max PSI? and how do the psi and rate as ml/sec correlate...I thought that if you do not excced the max rate you cannot create a higher pressure than whatever the max psi is?...tx in advance for any comments


The actual pressure required

The actual pressure required to burst a catheter is NOT the same as the pressure limit listed in the manufacturer's instructions for use. These instructions provide a limit much lower than actual burst pressure. For the rate and psi, the high pressure injector has a high limit of pressure set, usually 300 psi. The operator sets the infusion rate. As the injector works harder to overcome an increasing backpressure, the infusion pressure rises. Once it reaches the preset limit there should be an alarm. So if there is no backpressure from an occluded lumen or malpositioned catheter, the contrast agent should flow in at the set rate. High pressures from power injectors and hand injection can cause the catheter tip to whip, some more so than others. Small silicone catheters are more subject to movement with a rapid, forceful flush. Lynn

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

mary ann ferrannini
Thank you Lynn...Yes that is

Thank you Lynn...Yes that is what we have seen clinically with our silicone PICCs..though on occasion we have had a polyurethane PICC malposition post CT scan

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