Our hospital is reviewing and consolidating all IV tubing. We place a 6 inch extension set on all PIV's in the place of the traditional "buff cap" or injection cap. Our current extension tubing is NOT power rated and there have been incidents in CT when they use them. They will not take the tubing down to the hub of the catheter because of too many lost IV's with that method. So it was suggested to convert all the extension sets to power injectable as you never know on admission or IV start if the patient will need a contrast CT.
It will be a slight increase in charge but the hospital is willing to do this especially in light of the FDA recommendation that if the device is not rated for power injection do not use.
Is this standard practice? To use the power rated extension tubing for all patients? I welcome any comments.
Thanks, Peggy Hampton, RN
Clinical Education Specialist
Yuma Regional Medical Center
Yuma, Arizona 85364
There is not one specific statement in the INS Standards to cover this exact situation, however there are many statements that would apply to this situation. I think your rationale is right on target - to save the PIV by avoiding manipulation directly at the catheter hub, to safely inject the contrast agent with the complete system composed of all pieces that are rated for power injection, and to reduce the risk of contrast extravasation. I strongly support the idea that all PIVs require an extension set and the needleless connector should never be attached directly to the catheter hub. And you don't know who will and who will not require a CT with contrast. So yes, I would say your direction will meet the standard of care for your patients. Just make sure that the needleless connector is also rated for contrast injection under pressure. Also pay attentio to the amount of pressure that each component will tolerate, and the number of times each piece can tolerate being used for power injection. 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
Putting power injectable extension tubing on all PIV's may lead to all angiocatheters being placed, will be 20ga or larger. In anticipation of a power injectable diagnostic, where large bores are preferred. This is not in accordance with the smallest/shortest standard.
I personally have tried for the past 5 years to get our institution(s) to use 325 psi tolerant extension tubing on power injectable diagnostics only, to no avail. Congratulations on working for an institution that is pro Pt. safety.
Peter Marino R.N. BSN CRNI VA-BC Hospital based staff R.N. with no affiliation to any product or health care company.