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Use of 10 mL syringes for Power PICCs
Just wondering, maybe there are engineers who can answer this question.  If these power piccs are ok to 300 psi, why do we have to limit flushing to 10 mL or larger syringes?  It would seem to me that if you can hook up a pressure injector and send contrast through at 4 or 5 mL/sec and 300 psi, it would be OK to hand flush with a 3 mL syringe.  Isn't the reason we went to using only 10mL or larger syringes because of the pressure that would be exerted with a smaller syringe?  Yet, the instructions for use on 3 different brands of pressure injectable PICCs all say to only use a 10mL syringe or larger. 
Gwen Irwin
Good question! Gwen

Good question!

Gwen Irwin

Austin, Texas

Mari Cordes, BS RN  Nurse
Mari Cordes, BS RN 
Nurse Educator IV Therapy
Fletcher Allen Health Care
It was explained to me that it was more of a behavioral issue than an engineering one.  If we start telling staff, families in home infusion settings, etc that they can use a 3cc or 6cc syringe on THIS catheter, but you need to use 10cc or larger on THAT can probably imagine what would happen, eventually.
Yes, the Power PICC could most likely tolerate it.  Standardizing for everyone/every situation I believe was the intent.

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

The phycis of the issue that

The phycis of the issue that a 10 mL syringe will exert less pressure than a 3 ml syringe, however, there is no guarentee that this 10 mL syringe will prevent catheter damage totally. Even with a large syringe there can still be catheter damage if the hand size and strength is large enough and enough force is applied to the syringe plunger. Add in a very small amount of resistance and you can develop weakened areas on any catheter.

 I would say that behavioural issues are part of the answer but it will still remain a safer, but not totally safe thing, to use larger syringes for all flushing. 

Another reason may be (and I am guessing here) that the manufacturers did not wish to submit data to the FDA to make this change in their instructions for use. 



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

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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