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Rob Burr
SLIC catheter

One of our intensivists has begun using Arrow's Slic catheter in their introducer sheath as a medium term access device. I have been unable to find any references to this and have a general discomfort with the idea of leaving an introducer in for extended periods of time. He also wants the placement of the Slic cath to be a general nursing (ICU/CCU) procedure when the PA or Swan is removed from the introducer. At what point does such a procedure become a CVC placement and require full barrier precautions vs. just towels/gloves/mask? Any thoughts or references from the group?

Thanks,

Rob Burr RN

lynncrni
Introducers are Not CVCs

I am not familiar with the Slic catheter, But you have reason to be concerned if he is trying to use an introducer as a CVC. Look at the manufacturers instructions for use including their indications. Introducers are made of stiffer material; are too short to reach the SVC/RA junction which is the recommended tip location for a CVC; and carry lots of risk for air emboli or exsanguination if the connection with the set comes loose. I also do not know what you mean by a "medium term access device" as there is really no such category by the usual definitions. Once the PA catheter is removed, the introducer should be exchanged overwire for a true CVC with proper tip location. An introducer that is too short to reach the SVC/RA junction can not be used for infusion of therapies with extremes of pH and osmolarity or vesicants. All catheter insertions require full barrier precautions with the only exception being a short peripheral catheter.

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

Chris Cavanaugh
SLIC catheter

Rob, the SLIC is designed to be a central line, in conjuction with the MAC.  I would suggest you contact your Arrow Sales Rep and Clinical specialist to discuss your concerns and review a copy of the instructions for use of this catheter.  If you email me directly, I can send you those instructions for use along with the name and contact information for your Arrow Sales rep and clinical specialist. 

Chris Cavanaugh

[email protected]

Chris Cavanaugh, RN, BSN, CRNI, VA-BC

DML RN
The SLIC's that we use

The SLIC's that we use (pretty sure they're Arrows)  lock onto the intro,which reduces the disconnection/embolism risk. I agree that they are too short to reach the lower SVC,but I have learned not to be too picky when it comes to access in the ICU.

We (ICU RN's) can place a SLIC through an intro upon removing a PAC. Our policy only states to use "sterile technique",not maximum barrier protection,though I wonder if we shouldn't reconsider this. Our MD's invariably use the gown/hat/mask and drape set-up when they put a triple-lumen into an intro after a Swan comes out--maybe we should,too,for SLIC's.

 

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