We are noticing a marked difference in CVP readings when the 20 g lumen is used versus the 18 gauze. The BARD information indicates that any lumen in a power PICC can be used. We are concerned because obviously treatment decisions are being made based on the CVP reading. Are you using only the 18 g lumen for CVP? Anyone else notice discrepancies between lumen sizes?
I am not a vendor or rep. When it comes to pressure and volume there is a relationship that must be respected. I would recommend that the injection cap is not used on the lumen when connected to the CVP tubing. It is important to have a clear and patent lumen that you may want to dedicated to the CVP. I often see the Safe-Set connected in line with the CVP transducer so that blood can be sampled frequently. Any lumen that has been used previously for other infusions or frequent blood aspirations will develop "sluggishness" and less accurate pressure transfer. For a lumen previously used...may think about clearing that lumen with extra NS flush or if fibrin suspected...tPA.
Scott
Scott Gilbert RN, VA-BC, MPH
Honolulu,
I am not a vendor or rep. When it comes to pressure and volume there is a relationship that must be respected. I would recommend that the injection cap is not used on the lumen when connected to the CVP tubing. It is important to have a clear and patent lumen that you may want to dedicated to the CVP. I often see the Safe-Set connected in line with the CVP transducer so that blood can be sampled frequently. Any lumen that has been used previously for other infusions or frequent blood aspirations will develop "sluggishness" and less accurate pressure transfer. For a lumen previously used...may think about clearing that lumen with extra NS flush or if fibrin suspected...tPA.
Scott
Scott Gilbert RN, VA-BC, MPH
Honolulu,
I have not noticed any significant differences when using either lumen in the triple lumen Power PICC.
Not in pressure or CVP trace. In my opinion it’s all about keeping the lumens open and make sure to have a optimal tip placement.
The other day I even played around and used the Microclave in the middle. I found NO significant change in pressure or CVP trace.
Nurse specialist ICU/ANE/PICC.
Dep. of Neurosurgery
Umea University Hospital/SWEDEN