Questions On Central Vascular Devices

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

It can also occur during blood transfusion or during dressing change. The insertion of central catheters can occur in the Interventional Radiology or sometimes at the bedside. Regardless of the where the insertion process occur, a sterile field must always be maintained and sterile techniques must always be employed to prevent any organisms from being introduced to the central line into the patient. According to The Joint Commission (2013), many organizations such as Michigan Keystone Intensive Care Unit Project and Institute for Healthcare Improvement are actually adhering to insertion bundles to reduce the CLABSI rates. The bundles include hand hygiene, maximal barrier precautions, chlorhexidine skin preparation, avoidance of femoral vein, and prompt removal of central catheter. Furuya et al. (2011) studied the effectiveness of the insertion bundle and how it impacts the bloodstream infections for patients in the Intensive Care Unit. As a result, lesser infection have occurred when the compliance is high. As mentioned, the site of the catheter also needs to be considered in the insertion process. Avoiding areas such as the groin to access the femoral artery is recommended because this area can be easily contaminated with urine or feces. In addition, after the insertion of a new central line, all the used IV tubing

Before administration of any medication the patients chart should be looked at and varify that the patient has no allergies that could be related to said treatment or anything similar in their medical history. Also obtaining a baseline set of vitals prior to medication administration

A nurse-driven protocol is the recommended tool to be used by the nurse to remove catheters without orders following set CDC guidelines and prevent CAUTI

Lewis et al. explain in Medical-Surgical Nursing, a central line is a catheter placed into a large blood vessel for a patient who requires frequent or long-term access to the vascular system. The authors explain that catheters are used for the administration of high volume fluids, medications that are irritating (such as chemotherapy), long term pain medication, blood products, parenteral nutrition, and hemodialysis. Kaiser policy states four different types of central line used for patients: Centrally inserted catheters, peripherally inserted catheters, injection implanted ports and hemodialysis catheters. Centrally inserted catheters

Right Time: Check that the time is right for the medicine and if there is a requirement for before or after food.

There are various types of materials and equipment required to deliver medications via different routes examples of which are: patches for drug absorption i.e. in hormone replacement which can be placed in the most direct location, needles for subcutaneous injection i.e. in insulin dependant diabetes to allow the transfer of insulin into the body. Percutaneous endoscopic gastrostomy feed tubes for people with issues swallowing or with sever reflux to allow liquid food and medications to be administered whilst bypassing the throat and gullet.

Hold the catheter near the meatus (any passage leading inside of the body). Avoid tugging it. Then start to clean at least four inches of catheter nearest the meatus. Move only in one direction, away from the meatus (Fig.1). Use a clean area of the cloth for each stroke.

Step2: Main pharmacy pharmacist or clinical pharmacist in the responsible floor verify the order; if it is correct, then go to step3; if the pharmacist has some questions or concerns about the order, contact the physician or nurse practitioner to address. Pharmacists check the indication, effectiveness, safety, and convenience of the medication. Time spent: 5 minutes

Femoral arterial and venous access is traditionally the method of choice in infancy. The right and/or the left groins may be used. This port of access provides advantage of being away from the thoracic region for ease of catheter manipulation away from the radiographic cameras surrounding the child’s thorax. Umbilical arterial and venous access can be used in newborn babies up to 7 days of age. Other alternative route for arterial access includes: carotid artery, brachial artery, and axillary artery. On the other hand, alternative venous access includes: internal jugular vein, subclavian vein, axillary vein, and transhepatic venous access. Alternative vascular access (ARVA) is occasionally required due to the lack of femoral vascular patency or the need to position the catheter at a particular trajectory not provided through the traditional femoral access. The use of ARVA is safe and effective for performing a wide variety of interventions across. In addition, its use may improve the results of selected

A percutaneous central line is entered into the patient’s subclavian vein. Because TPN solution is concentrated it is better to have CVC access in the subclavian vein so the solution has less distance to travel to its destination. This reduces the risk of the line clotting or damaging the vein.

Intravenous fluids are administered through either a central or peripheral line. A central line is an intravenous line made of a small flexible tubing used to intravenous medications, blood, or to collect blood samples. A central line is inserted under the skin away from the vein, and it comes out from a subcutaneous route. A cuff is placed around the tunneled part of the line securing placement and helping to prevent infection to the insertion site. Central lines are inserted into large veins in the central circulation (Caring, 2015). The catheter is threaded into the internal or external jugular vein; it can also be threaded into the lower third of the vena cava leading to the superior part of the right atrium. When inserted, a chest x-ray is done to confirm placement and position of the catheter, and to check for pneumothorax (Central, 2015). A peripheral line is a vein in the arm, hand, or in an infant in the scalp. A peripherally inserted central line, also known as a PICC line, is another type of catheter used to administer intravenous medications. PICC lines are inserted in the inner arm toward the shoulder, moving to a

The brochure talks about several things that can help lead to a better understanding of the care being provided to the patient. There are several things that can be taken into consideration, such as; Have the information written down that you need to discuss with the doctor (allergies, medications, health concerns etc.). Ask more questions if you are having trouble understanding the care being provided and tests/imaging being ordered.

A central venous catheter is known as a central line or a CVC. A CVC is a thin flexible catheter that is inserted into a large vein near the heart in either the arm or the chest. (Web MD, 2016) This central line is used to provide medication, fluids, nutrients, or blood products over a long period of time. This is generally used for patients who have chemotherapy, frequent blood draws, need additional nutritional support, or have kidney failure. (ATS, 2015) There are several considerations to keep in mind when a CVC is being administered such as understanding why a CVC is being placed, safety guidelines, teaching considerations, and ways to care for the CVC.

The use of intravenous therapy in the hospitals is now considered a routine therapy. In 2016, DeVries and Valentine stated that 70% to 80% of hospital patients have peripheral intravenous lines at some time during their stay. A peripheral intravenous (PIV) line is a small hollow tube (catheter) that is inserted into a vein and can be connected to special tubing. PIV line is commonly used to administer medications or fluids directly into the vein. The article “Intravenous Therapy: A Review of Complications and Economic Considerations of Peripheral Access,” states that the history of intravenous (IV) therapy dates back to the Middle Ages. Dr. Thomas Latta pioneered the use of IV saline infusion during the cholera epidemic and in the 20th century, two world wars established a role for IV therapy as routine medical practice (Dychter, Gold, Carson, & Haller, 2012).