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revIVe

2020
Team Members:
  • Brooke Hayley
  • Niranjanaa Jeeva
  • Disha Makodi
  • Natsuha Omori
  • Shayan Roychoudhury
  • Noah Yang
Advisors:
  • Clifford R. Weiss, MD
  • Youseph Yazdi, PhD
  • Ami Kumordzie
  • MiKaela Olsen

Abstract:

Over five million central venous catheters (CVC) are inserted in the United States every year, to allow direct delivery of medication into the blood. Up to 15% of these catheters can become occluded, often due to blood clots clogging the lumen of the catheter. Once occlusions are detected, they must be cleared immediately to prevent downstream complications. These clots can delay treatment and become an incubator for bacteria, increasing the risk for Central Line-Associated Bloodstream Infection (CLABSI), which leads to 28,000 deaths in the US per year. Patients with occluded catheters are nearly three times more likely to develop CLABSI. In the hospital, inpatients with occlusions are treated with time-consuming and expensive declotting agents If the occlusion is not treatable with the agent, patients must have their CVC replaced, increasing their length of stay at the hospital. To prevent catheters from getting occluded, the gold standard as stated in the Infusion Nurse Society policy is to flush the catheter with saline using a start-stop method, where 10 short boluses of 1 mL are delivered with a syringe, interrupted by brief pauses. Several studies have shown that pulsatile flushing is at least twice as effective in clearing the inside of the catheter. However, interviews and observations at the Johns Hopkins Medical Institute have revealed that nurse compliance with pulsatile flushing is as low as 6%. Therefore, nurses need an easier and quicker way to introduce pulsatile flow in lines in order to prevent thrombotic occlusion of central venous catheters. RevIVe presents PulseFlush, a disposable syringe that makes sure that the gold standard of flushing is met, regardless of how busy or experienced the nurse is. Nurses can push the syringe continuously, while the device creates the pulsatile flow profile. Consistent pulsatile flushing will break up any debris inside the catheter, preventing clots from forming and bacteria from growing inside. Nurses no longer have to actively push and pause the plunger of the syringe, making it easier for them to comply with the standard of care.

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