I was interested in the comments regarding tissuing and occlusion pressures.
I am sure in my own mind that tissuing will occur regardless of occlusion pressure setting if the clinical conditions exist, i.e. cannula movement, fragile vein, poor positioning etc. There are examples of tissuing occuring with gravity infusions where the in line pressures are marginally above the venous pressure to ensure positive infusate flow.
The purpose of occlusion limits as has been well descibed earlier it to prevent bolus delivery and indeed pump or disposable damage, not tissuing. The idea of trending is Ok so long as someone is there to view and interpret the data.
I know many a sales pitch has been built up on the benefits of pressure monitoring and tissuing incident reduction but I remain sceptical. I am firmly in the camp of "routine observation of the IV site" as a method of prevention. If the reply comes back that there arn't enough staff to undertake the observations, then there arn't enough staff to interpret pressure trend data either!
We have remained with the manufacturer's default setting for all infusion devices apart from those for neonates for whom we reduce the setting by 50%. Tissuing events as reported to me have been low to non existant.
Lucky? - possibly but I wait to be convinced.
Brian
