Hello all,
I was wondering if anyone can speak to the use of pressure infusor bag use with power PICCs in emergent situations or high flow rates. In my facility the anesthetists are routinely placing large bore Peripheral IVs in patients with functioning PICCs. Their concern is that they won't be able to give large volumes in an urgent/emergent situation. They do not use infusion pumps,only gravity lines. A recent example of this is a patient who went for an urgent bowel resection with a functioning double lumen power PICC. They did not use it and proceeded to place an 18ga iv (after 7 unsuccessful attempts!) Our PICCs are rated for 300psi, we'll above the maximum pressure of an infusor bag. Would it be safe to suggest the use of a pressure infusor with the PICC if needed,vs routinely starting another line? Am I making any sense? Any thoughts/feedback is welcome.
Kerry RN
Pressure is pressure regardless of whether it is coming from a manual push, an electronic pump, or a pressure bag. Are you absolutely certain that the pressure bags in use in your hospital have a maximum of 300 psi? If so, and the PICC you are using will accept that level of pressure, there should be no problem. But do not assume that these bags have this as their max pressure. I have seen some of these pressure devices that go well above 300 psi. Also make sure that the measurement is in psi and not mm Hg. If mm Hg, then convert by this - 50 mm Hg = 1 psi. If your bag is 300 mm Hg that is 6 psi. The length of a PICC adds resistance to fluid flow, so I can understand the anesthesiologist concerns. Lynn
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
Hi Lynn, thank you for your reply. I wasn't clear, our pressure bags are 300-500mmhg and our PICC are rated for 300psi. I was hoping someone (an expert like yourself) would confirm as, you say that pressure is pressure, regardless of where it originates. I suppose where I was going with it was when does it become unreasonable for the OR not to use a PICC. I spoke to one of the OR nurses and apparently it took 12attempts before they were successful in initiating a peripheral line. They then used a heparin infusion,under pressure to keep the line open. I do not know the concentration . I am going to follow up with administration and our clinical educator as this seems entirely unreasonable . Thanks again for your expert support.
Kerry
K.McDonald RN