Has anyone worked with this infusion/short term dialysis catheter in the home infusion environment? We are being asked from our hospital referrals to use these lines to administer infusions at home. Per Bard "Third (17 Ga) Lumen exits distal to the dialysis lumens and is indicated for intravenous therapy including infusion of medication and blood draws, power injection of contrast media, and central venous pressure monitoring". Our policy has been to not work with dialysis lines in the home infusion world, but now that one of the lumens is for medication administration we are being asked to use it at home. Just trying to get more information and see if this will be a trend in the future. Any info or experience with this would be greatly appreciated.
Thank you, Carole
where is the device to be inserted? Read the IFU carefully, there is a specific time frame for dwell depending upon insertion site.
In out hospital setting we treat the "pigtail" lumen as any other CVC with regaurds to flushing and medication admisitration, we do not do anything with the dialysis ports.
Rose Galyan RN, BSN, CRNI
Speciality Practice Nurse
Vascular Access Team
Indiana University Hospital Bloomington
[email protected]
This VAD is labeled as a short term device and is in the same category as the new midline devices promoting up to 29 days of dwell. However, these statements are NOT based on clinical studies with these devices. The FDA requires each manufacturer to state in their first applications to the FDA whether their device is for short term (less than 30 days) or long term (greater than 30 days). This is stated based on how the manufacturer designed and promotes the device to be used and it is definitely NOT based on clinical use of the device or clinical outcomes at all. I have had several discussions with manufacturers who promote this misconception. So I definitely stand by my first statement that there is no recommended dwell time or maximum dwell or optimum dwell for any type of VAD, and that includes this one and all others who manufacturers promote this language. It is very confusing. 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
On page 6 of the Trialysis IFU it says:
Contraindications
The catheter is intended for short-term vascular access only and is not to be used for any purpose other than indicated in these
instructions. The catheter must not be left in the femoral vein longer than three days. It is recommended that jugular and subclavian catheters be replaced after 4 weeks.
I interpret this to mean a maximum dwell of 3 days in the femoral site per manufacturer IFU.
What is their evidence to support that statement? These statements are not included in any document from SHEA, CDC, APIC, or INS. I did not look at the references included in this IFU but I would consider a thorough examination of the referenced literature warranted to understand the research design and outcome. 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
In house we treat the third lumen pigtail as a CVC, however, we do not discharge patients with these types of dialysis catheters.
Danielle McClain RN, BSN