Evaluation Of A Central Venous Catheter

Every day a registered nurse with specialized training in peripherally inserted central catheter insert this device into a patient’s vein every day. There are various reasons why a patient might need this catheter. It aids in transferring nutrients, medications such as antibiotics into the body. Patients who have continuous blood draws benefit from this catheter. It is an easier access and minimal needle sticks to the patient. Patients who entail for this catheter are cancer, critical care or nutritional impaired patients. Peripherally inserted central catheters are commonly referred to as PICC lines. It is a slim and hollow tubing that is placed in an area anterior above the elbow. Once inserted the goal is to thread the line through

Only when it is absolutely necessary should a catheter be inserted into a patient. Every patient is assessed for the need for a Foley catheter. If the Foley is inserted, assessments are also then done daily to see if the need is still valid. If the reason is not justifiable the catheter must be removed from the patient (Joint Commission releases new NPSG for CAUTI, 2011). Nurses must follow guidelines while inserting indwelling catheters as well. Aseptic technique is critical to maintain during this process. The use of sterile equipment and a sterile procedure helps to reduce the risk of CAUTI. If in any way the catheter becomes contaminated during the process of insertion, the nurse should discard of the entire catheter and start with a new, sterile kit. Proper hand hygiene is very important before and after contact with indwelling catheters to decrease risk of infection. Maintenance of a close drainage is system is also important that way bacteria are not able to get in and cause infection (Revello & Gallo, 2013). Decreasing the number of times Foleys are inserted and how long they stay in for can help reduce the risk of CAUTI since the longer a Foley stays in, the higher the risk of infection becomes. Nurses must keep the catheter line patent, with no kinks to allow urine to flow freely through into the collection bag. When a urine sample must be obtained it must be done in a sterile

Central line bundle is a group of evidence-based practice strategy for patient with central catheters, when implemented together, produce better outcomes than implemented individually (Institute of health care improvement, 2010.). The main elements of central line bundle are hand hygiene, maximal barrier precaution upon insertion, Chlorhexidine skin antisepsis, optimal catheter selection, and daily review of line necessity with prompt removal of unnecessary lines Aseptic technique when using and caring for a central line catheter can decrease the chance of contamination in this critically ill infants. Staff education on adherence to aseptic technique and strict central line care guidelines are essential to decreasing bloodstream infections.

PICCs lines have become well recognized as reliable central venous access devices (VADs), with lower potential for complications than short-term central venous catheters. PICCs first gained popularity in the 1980s, and their use has grown steadily since then. They were initially popular in many parts of the United States due to the need for venous access in home care patients. They have grown in popularity because of their reduction in potential complications and costs compared with short-term central venous catheters, and because PICCs can be inserted by registered nurses who have been trained in the procedure.

Pt requires 20 gauge IV for _______. 20 gauge catheter inserted to the right anterior forearm, first attempt. Flushed with 10 cc normal saline. Stat lock in place, covered with transparent dressing. Pt tolerated well with no complaints of pain or irritation upon flushing, no visible swelling or bruising. Sharps placed in approved container, patient’s bed lowered as far as possible and assisted to comfortable position. Reassessed in 5 minutes for bleeding , none noted.

The authors used quite an extensive list of references, ranging in time frame from the years 1982-2014, which were used appropriately throughout the article and were aimed to give readers evidence on the background and complications of Central Venous Access Devices. The authors followed APA guidelines and used credible resources.

When hearing the term PICC line it maybe rather confusing; that is unless you’re in the medical profession or have a family member that has one. First, the name that groups all of them together is called; a central venous catheter. A PICC line is just one of many. It is described as a peripherally inserted central catheter; otherwise called PICC line. It is a long, thin, flexible tube that is inserted under the skin into a vein in the arm rather than a vein in the neck or chest. (“WebMD”). The purpose of the PICC is to give medicines, fluids and blood products over an extended period of time. Those with cancer, kidney disease, diabetes, Lyme disease and total parenteral nutrition or (TPN) are common reason that a PICC line could be used for. PICC lines are thought to be a safer and simpler way to distribute needed treatments. Fewer than 10% of patients have trouble or generate a venous injury. (“Peripherally Inserted Central Catheters and Other Intravascular Devices”, 2014).

Inserting an IV into a patient can be a painful experience, especially if the individual has veins that are hard to visualize or palpate. Some reasons for difficulty inserting IV catheters include obesity, veins that roll or blow easily, dark pigmented skin, and dehydration. With the help of modern technology, devices called Accuvein finders have made it a less painful process for patients. The author will discuss how these devices have compared to palpation and inspection on hospitalized patients in the last five years. This paper will focus on three articles that tested the Accuvein finders and the results of each.

Central venous catheters (CVC) have various uses for patients in both the inpatient and outpatient settings. Their purposes range from administration of total parenteral nutrition, to administration of vesicant medication, to providing access to patients with poor peripheral vascularity, as well as hemodynamic monitoring (Alexandrou, Spencer, Frost, Parr, Davidson, & Hillman, 2009, p. 1485). Traditionally, insertion of CVCs have been performed by surgeons and internal radiologists. However, with the advancement of roles in nursing, there has been ongoing research supporting the pro stance on the practice of nurse-led central venous catheter insertion.

Arterial catheterization is a commonly performed invasive procedure in the ICU and anesthetized patients, facilitating accurate hemodynamic monitoring and frequent blood sampling. The insertion of arterial catheter especially in patients with hypotension, edema, and obesity, is often difficult and may require multiple attempts. Repeated attempts may lead to more difficult catheterization due to arterial spasm and may increase the incidence of thrombosis and hematoma formation [1]. The radial artery is the commonest site for catheterization owing to its superficial course and its dual arterial supply to the hand [2].

Starting Peripheral Intravenous (PIV) access has become so common a practice among Registered Nurses (RN’s) that many nurses do not give much thought as to how to prepare the site for PIV insertion. Many times, finding a vein takes the priority especially in the older patient population. Teaching PIV insertion has also become a routine: Watch the video, practice on the mannequin arm, and have the student start one on a live patient. Recently, the videos in use for the students preclinical learning have changed. Mosby videos used to show the RN wiping the PIV site with one alcohol swab in a concentric circle to clean the area. New Mosby videos now show the RN wiping the PIV site with three alcohol swabs using the

• Depending on the medical procedure you are having done, an IV tube will be inserted into one of your veins.

Catheters have always been a way to introduce infection into the body. Although, they are needed in some cases, it is of very high importance to insert them with aseptic technique and to not insert them if there are other ways to properly care for the patient. Sometimes as a ED nurse, nurses may get in a rush, and lack the proper techniques or by less wait time and time being an issue. I have long term experience as well, and catheter care, and removing catheters as soon as possible remain of high importance there as well. Without proper care it easily introduces infection for a urinary tract infection.

1- Tunneled Central Venous Catheters : is a long flexible tube which one end be placed in or near

Reports of vascular perforations during use of soft polyurethane catheters are rare, although Duntley et al. described eight patients with pleural effusions, detected some days after insertion of subclavian or, in one case, internal jugular venous catheter (Duntley 1992). In one of these patients, the catheter tip seemed radiographically to be in an extravascular position at the time of clinical diagnosis. The pleural space in each patient was nevertheless filled with the solution intended for parental nutrition. In only one case, there was a return of blood through the catheter, possible indicating that most catheters were placed into the pleura immediately at central venous cannulation, possibly following guide wire-induced vascular injury. Vascular perforation may often be attributed to immediate cannulation-associated injury (Kalen 1991; Robinson 1995), and most morbidity from vascular CVC perforation is due to infusion of fluid into pleura or pericardium (Duntley 1992; Collier 1995; Walshe 2007), although avoidable by careful aspiration of blood, or (if no blood can be obtained) chest X-ray with iv contrast injection, before clinical use. Since any central venous catheter appropriately, according to tradition, positioned within the SCV could be associated with vascular perforation - knowledge