FAQ

Frequently Asked Questions

  • Can we DRAUP on Trialysis catheters?  — The DRAUP protocol works on all supradiaphragmatic central lines. For the process of DRAUP in the ER, the dialysis catheter insertion is rarely the delay in initiating treatment. You CAN DRAUP to use the distal port of the Trialysis to start vasopressors but our nephrology colleagues will likely require a CXR before HD initiation
  • How do I DRAUP if I’m still sterile during the procedure? —DRAUP is for post CVC confirmation. You should only perform it after completion and appropriate dressing of sterile wound site
  • Do I need to agitate the saline when I flush? — NO agitation required for DRAUP, in fact, it is discouraged
  • Do I have to use a sterile packaged saline syringe for the flush? —No, you can use a standard flush
  • What if I forget to save my images? — then you cannot DRAUP. DRAUP requires images saved to PACS and a separate procedure note in EPIC (.DRAUP)
  • Does it have to be the same person who puts in the catheter that confirms? — No, CVC insertion should be provided by any appropriately trained personnel. DRAUP (which only addresses post CVC procedure, only specially trained residents can DRAUP
  • Who can see my ultrasound images?—anyone who has access to PICOM/Qpath. 
  • Is the DRAUP note in EPIC a separate procedure note?– Yes. Use “.DRAUPIN” or “DRAUPOUT” in a separate procedure note. This should not be placed at the bottom of a CVC procedure note.
  • Do I have to put in a separate ultrasound note for the cardiac & pleural images obtained?—No, your EPIC smartphrase “.DRAUPIN” already states that images are saved. You will not receive an addendum for procedure image.
  • What are the critical actions for each ultrasound image?— Labeling “Flush” when you are flushing the distal lumen of the catheter and labeling Rt or Lf for the neck and pleural exam.
  • What attestation does the attending need to write? — After reviewing stored images from residents, the attending should use the same ultrasound procedural attestation that they reviewed images or where immediately present and agree with the residents interpretation report