Our institution is switching to BARD Solo Piccs. In the past, there was an issue with increased occlusion/thrombosis. I understand there has been a redesign. I would like to know if anyone has had current experience with these catheters: pro and con. Thank you!
We use the BARD Power PICCs and like them very much. We did not see an increase in our occlusions but also did not see a decrease. We are proposing a change of needleless caps to a neutral pressure to hopefully resolve the issue.
We switched several years ago to the SOLO PICC's and have had great results. While people 'thought' that there was an increase in occlusions, when we looked at the actual numbers, our tPA use was reduced, thus we had less thrombosus that we thought. Whenever you switch to a new product, there is more concentration on that particular area, so anything out of the norm can appear to be bigger than it really is. We use the SOLO's in both peds and adult populations and at 4 of our 5 facilities in our system. (the 5th one will be going live next year).
Janine Pritchett, RN-BC, BSN, VA-BC
Clinical Educator - Vascular Access
We had some issues with the 6 fr triple lumen catheters. Especially in ICU patients that were not moving. UE/DVTs were high. Verchow's Triad in motion. I had a long discussion with the ICU doctor concerned with the issue and the problem of no one wants to own passive range of motion for these patients. At recommendations we had already quit placing these 6 fr catheters in anyone with less than a 5 mm vein or very close to it if the other options for central access were higher risk for other reasons.
Since then Bard came out with the 5 fr triple lumen catheters. Our symptomatic DVT rate went down significantly. We also teach family present to do range of motion on patients not moving just as we teach them our saying for this hospital "clean hands and scrub the hubs". Families want to do something many times for their loved ones and this is an easy one for them. I even encourage them to remind sleepy or forgetful patients to do their range of motion if I think that the patient is going to tend to "baby the arm". We have not used any other product so I have nothing to compare with. Our system contract has been with Bard for a long time.
I think education will help with any product, just as we educate people on what to do for plane rides and long car rides. It certainly can't hurt.
We didn't have significant problems with occlusion until we went to a different cap. I had no say or control over that. It was considered to be a cost savings but when our cathflo usage went way up we change our protocol to twice a week cap changes. Everytime a line won't work, the first question is,"have your changed the cap?"
Mary Penn RN Vascular Access Team
St Charles MO
Disclaimer this is from a home care/home infusion perspective (and in addition to working home care and home infusion, I am a CNT for Genentech)
We in home care and home infusion see a variety of devices passing though our desk. Early on we found that there were issues with occulsions with this device when using saline only flushing. As many of our patients are mobile, I don't feel the immobility was a factor. We chose to lock these lines with Heparin due to this issue. The rationale included the following - not all of the home care agencies declot in the home, if they do it adds an extra very lengthy visit to their busy day, and if they do not declot in the home some of our patients cound not get back to the hospital, ER or clinic to have the line evaluated and declotted (factor in if they did get there sometimes the line was "powerflushed", the patient sent home only to have issues in a day or two and we go through the process all over again. We have not had an increase in issues using the heparin lock.
So from where we sit saline only is not ideal for us
Ann Marie
Ann Marie Parry, RN, CRNI, VA-BC
[email protected]