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ann zonderman
Power PICCs

for anyone inserting/ using Power PICCs

Do you have patient criteria for selection to place a Power PICC

What is it?

Do you place power PICCs for home or LTC patients?

Under what circumstances

What is you flushing protocol?   solution?   Frequency

Are you seeing any occlusion issues/ problems with these catherters?

Please describe

What are your doing about problems?  

Thanks   Ann Zonderman

Alma Kooistra
We have a rather loose

We have a rather loose patient criteria......we use power PICCs in patients who are critically ill, new admits with abdominal diagnoses that are likely going to need CT scan and possibly TPN, actually most people with gut issues who are still in the diagnostic phase of hospital stay.  We started using them around 6 months ago and are using them more frequently than I thought we would.  The staff love them.

I can't imagine placing for home or LTC use unless the patient was long term on TPN.  I think it's too much catheter for basic antibiotic, etc infusion outside of the hospital.  I feel that way about all dual lumen catheters.

Home or LTC our PICCs are often flushed only daily at the time of infustion.  This seems to work well (we use an open-ended PICC).

We're not seeing problems with these lines at all. 

Alma Kooistra RN, CRNI

 Early on we tried to

 Early on we tried to develop guidelines for the use of Power PICCs, but the results were unsatisfying.  We had a patient admitted with osteomyelitis of the toe for long term IV antibiotics, so no expectation of a diagnostic workup.  He got a Groshong.  Two days later the guy starts complaining of chest pain, so now they want to do a CT angio study of his lungs to rule out a pulmonary embolus and all he has is a Groshong PICC.  This type of thing happened several times.

Once BARD replaced the 6 French Power PICC with the 5 French Power PICC, the main advantage of placing the Groshong was gone, at least in our setting.  We have had no increase in the incidence of plugged lines or thrombosis with the Power PICCs.  They are much more durable and versatile.  If the patient lands in the ICU, the line can be used to monitor CVP.

We have gone to the Power PICC for more than 90% of our lines.  We still keep a few Groshongs around for the rare Chemo outpatient who does not get an implanted port, and our Hospice patients who only require a small single lumen line, but next month BARD is coming out with a single lumen 4 Fench Power PICC, and that will probably replace the single lumen Groshong we now use.

Jerry Bartholomew RN, BSN, CRNI

VA Medical Center, Spokane, WA

Jerry Bartholomew RN, MSN, CRNI

VA Medical Center, Spokane, WA

Do you flush your Power
Do you flush your Power PICCs with heparin flush, or saline (using positive displacement caps)?

Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center

The use of saline only for
The use of saline only for any catheter depends upon the instructions from the manufacturer of the specific brand of needleless connector device being used. Some of the positive displacement connectors state saline only while others do not. 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

our home care affiliate has
our home care affiliate has strongly urged us to avoid power PICCs in the we are careful about our selections...They state the power picc requires increased flushing(vs Groshong) and are wary of the open end. ..we evaluate each patient and will place PIV's for contrast studies on home care patients
The Power Groshong,when

The Power Groshong,when available,should prove very popular!


It is almost impossible to

It is almost impossible to predict the future so I would look to providing the same standard of care and device type to all patients. 

Power injectable vascular access devices of all kinds will become the standard of care not the exception soon.  In all vascular access devices.

Kathy Kokotis

Bard Access Systems

We are just starting to
We are just starting to trial the Power PICCs.  At the same time, the MICU and SICU units are trialing positive displacement caps (Flolink) - our hospital has been behind the times and still using the original ICU Med negative displacement caps.We're having trouble with plugged Power PICCS now, and despite education and reinforcement about changing flushing technique to allow the positive displacement to occur, I'm assuming not every nurse is doing this yet.Lynn - you also mentioned syringe issues - can you elaborate?  We're using Kendall monoject luer locks and also the Kendall prefilled.

Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center

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