I'm fairly new at PICC insertions. I'm wondering if I can get some feedback on the Power PICC Solos. We started using them exclusively at our small hospital, however we have had more problems with them clotting off. We have trained all our nurses on proper flushing etc... They still seem to clot more frequently then our previous Groshong catheters. I've talked with a few RNs at home health agencies and other hospitals and some say they have no problems and others say that they do. Any more feedback?
Luana
We too have seen a huge increase in our CathFlo use when the local hospital switched to the Bard Solo PICC...over a 70% increase!! We have been tracking this and even discussed the problems with the manager of infusion therapy at the hospital and she said that the nurses placing them love the ease of insertion and that they were not going to switch. We have educated the patients, home care agencies and long term care nursing staff on the proper flushing and blood draw technique per manufacturer's recommendations and we still hare to use CathFlo like drinking water. The main issue has been with a lack of blood return and on a few occassions we have had complete occlusions also. I spoke with the rep at the INS meeting in Orlando in May and told her of the problems and she insists it is user error. I will keep tracking all of our visits to the home and nursing homes for CathFlo instills and will keep reporting the the data to the hospital and maybe I will get them to take notice! I know there are nurses who love these catheters but my nurses and I do not care for them one bit!
Marianne Valentine, RN, BSN, CRNI
Nurse Manager
Pharmacare Infusion Services
Cumberland, MD
Thank you Marianne!
Can you let me know if you hear more on this?
Luana Philpott RN
[email protected]
Luana Philpott
We are actually having the same problem with the Bard 4 french dual PICC that is not a power PICC. We use heparin but compared to the Deltec that is also placed, I have seen twice the number of manipulations to these catheters due to complete occusions or no blood return. It has been hard to convience the insertion team because they too love to place them. It is very frustrating to have to deal with these lines on a daily basis. Theresa Reed, Texas Children's.
You are not the only ones with this same problem. Do a search of this discusson forum to find several other comments posted about this. 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
I have used solo piccs exclusively in the past. We did have a problem with occlusions and blood return more frequently as compared to non-solo piccs and groshongs. All I can recommend is to still use heparin as part of your flushing protocol, if you aren't already. I now use the regular bard power picc and we don't see nearly as many occlusions. Our cathflo usage is fairly low, but it takes constant education on proper flushing no matter which line you're using.
Mike
See the new INS Standard #45, page S59 Flushing and Locking. Practice Criteria N & O - heparin 10 units per mL is the preferred lock solution after each intermittent use, 7 references, ranking of III. 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
Supposedly these Solos only require saline flushes, unlike the regular open ended power piccs that require heparin. We went with these to prevent any potential HIT complications. I will try your suggestion and do a search and see what others are saying.
Thank you,
Luana
Luana Philpott
Do you flush your lines Q12 or Q8hrs? Do you send patients home with power piccs?
Luana Philpott
We have been using 3ml Heparin 10units/ml on all PICCs unless the patient has a documented case of HIT (actually have one on service now). Even with using 10ml NS followed by the heparin we still are having problems with the Solo PICC only.
Marianne Valentine, RN, BSN, CRNI
Nurse Manager
Pharmacare Infusion Services
Cumberland, MD
Are you using positive pressure caps and not neautral or negative caps? The BARD rep said that the solos are best with the positive caps. She also said that some of the neutral caps are slightly negative, just not as negative as the specified negative pressure caps.
Luana Philpott
We haven't had a big problem with the Solo's until about 6 weeks ago when we had a rash of them clot off. I even spoke with an RN at Bard who stated it was likely our clave but we have had no change in claves in over 2 years. Nontheless we are trying out a positive displacement cap instead of our neutral one. In the meantime we are using SASH protocol for the Solo's to prevent so much use of Cathflo. Bard recommends a neutral or positive displacement cap. The Solo is a valved catheter and is supposed to reduce or elimate the need for Heparin but that is not the case for all patients. Here is a statement from the FAQ section.
" PowerPICC SOLO*2 catheter does not require the use of heparinized saline to lock the catheter lumens. However, use of heparinized saline will not adversely effect the catheter and may be necessary based on patient status or use of alternate flushing and locking techniques."
I hope this helps.
Theresa Strunk, RN, CRNI