Our ICU called us for advice on flushing protocls on mantaining a Cordis introducer. We responded that keeping an introducer as a central line should not be done at all. Their response was a polite "thank you for your perspective". Are we wrong to discourage the use of maintaing introducers as access?
IV Therapy Dept. Elliot Hospital Manchester NHÂ
No, you are quite correct. Those introducers should be exchanged over a wire for a regular central venous catheter and should never be used as a stand-alone infusion catheter. First, they are no long enough to be considered a central venous catheter. Second, they should never be transferred out of the ICU because of their large size. If the administration set were to become disconnected from this introducer, the immediate results would be complete exsanguination or massive air emboli. A patient receiving one-on-one care in an ICU is a very different situation than the nurse to patient ratio on the general nursing unit. It then become a more serious safety issue.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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
Due to the info that Lynn stated, we do not allow any Cordis to be transferred from the ICU. We have had near misses in the very distant past that support this, including near exsanquination and near air embolism from a "cracked" Cordis. The other issue is that they are not central.
We have had support for this decision to not allow them outside of ICU, based on patient safety issues.
Gwen Irwin
Austin, Texas
When I started in my position 5 years ago this was common practice from PACU to the surgical unit. Many of the nurses were new graduates who didn't know any better as to whether this was a "normal "central line for IV use. As a home care, oncology and infusion nurse for over 30 years, I knew better and stopped the anesthesiologist from sending patients to the unit with a cordis.
There are so many complications that can and do occur with this type of device, I only had to google it and had more than enough evidence based practice to support my objection. Added to this our CNO is a critical care nurse who had experience with this device and backed me up.