Does the INS or another organization have standards for power injection of contrast material? I have read earlier posts but I am unable to access the ACR Manual on Contrast Media.
My organization has recently had incidents of IV tubing rupture and I am trying to gather best practices.
Thank you,
Celia
We have had this problem also. We use an extension set rated 325 psi ,ours is Baxter #7N8300.
You have to also be careful the IV site is a clean access, ie no back wall puncture because your vein can also blow.
All pieces and components of the complete infusion system must be compatible with the pressure being used for any infusion pump. Many years ago, the FDA issued a warning about this issue for the VAD but not the other components. However, having all components of the system to be able to tolerate those high pressures only makes common sense and I failed to understand why we need another document to tell us this. A ruptured VAD would pose more risk to the patient because that device is actually inside the patient. However, a rupture or damage to any other component will require that the injection be stopped, the damaged pieces removed, and the injection started again. Timing is a huge issue for the contrast injections. This situation would mean that the patient receives more contrast than required by loosing the effect of the portion that had already been injected before the damage. It will also add costs by needing to replace those components, time of the nurse and tech, and delay the use of that radiology room for the next patients. This means throughput is slowed and that costs money. 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
You can Google the ACR Manual of Contrast Media, or go to the ACR website to download a copy for free. www.acr.org
Regarding your IV tubing rupture--were you using only IV tubing that is pressure rated to the the maximum pressure on your injector? You will need to check with your manufacturer's product inserts to find out. That includes the extension sets, and needleless connectors as well. If it is pressure rated and failed, please submit a report to the FDA via their website and let the manufacturer know as well. Your purchasing department can put you in touch with your manufacturer's reps.
Chris Cavanaugh, RN, BSN, CRNI, VA-BC