Central Line Flashcards
What are Central Venous Access Devices (CVAD’s)?
-are catheters placed in large blood vessels (subclavian, jugular vein) for clients who need frequent or special access to their vascular system
-allow for immediate access to the central venous system
-reduced need for venipuncture and reduction of extravasation (allowing for drug administration that are potential vesicants)
-inserted for diagnostic or therapeutic reasons, such as blood sampling
-central venous pressure readings, administration of medication (pH<5 or >9), fluids, total parenteral nutrition (TPN) and blood transfusions
what are the different CVADS
Centrally Inserted Catheters:
-central lines that have ports in the center of the body
-in the neck or in the groin
Peripherally Inserted Central Catheters:
-in the arms
-the end of the cath still ends at the right atrium
Implanted Ports-surgically place (chemo pt)
what should your choice of CVAD be based on
-The needs of the patient,
-The reason the line is required,
-The length of time it needs to remain in situ (long term vs short term)
why would you use a pick line
-when the duration of IV therapy will likely exceed six days
how often should a short term central line be replaced
-every 10 days (rewired)
what details are important for a short term central line
-Non-Tunneled- Single, double, triple or quadruple Lumen
Physician Inserted through subclavian:
-Use a subclavian site, rather than a jugular or a femoral site, in adult patients to minimize infection risk
how is a long term central line inserted and where is the exit site
-Surgically inserted
-Exit site is usually mid-to-lower thoracic or upper abdominal regions
where is the long term central line inserted and what kind of pt need them
Dacron cuff near the subcutaneous exit site anchors in place, acts as a securing device, and antimicrobial barrier
how do you reduce the risk of infection for CVADS
-use a CVC with the minimum number of ports or lumens essential for the management of the patient
what are the different types of tunneled central lines
-Tunneled-Cuffed Central Catheters
-Broviac, Hickman
-Groshong
-Single, dual, triple, or quadruple lumens
what are the complications of central lines
-catheter occlusion
-embolism
-catheter related infection (local or system)
what are PICC lines used for, what is the site selected, what technique is used and how long do they stay in)
-Used to deliver all types of infusion modalities
-Tip placement should end in SVC
-Power PICC available for maximum injection rates without catheter rupture (example: CT scan injections)
-Site selection is usually basilic or cephalic
-Strict sterile barrier technique for insertion
-Used for >1 week- 6 months or longer
describe PICC lines long term therapy
-Placed by competency validated RN
-Dwell time from over 7 days to 6 months or longer
-Use of ultrasound guided insertion often used
-Single, double, or multiple lumens
describe implanted ports
-Surgically implanted CVAD connected to reservoir or port
-Completely closed system
-Self sealing port with an outlet catheter
-Accessed with non-coring safety needle
-Requires a “Huber” or non-coring needle
-doesn’t bleed
-Needle sized from 19 – 24 gauge and from1 – 2 in.
-Dual ports available
what kind of care do implanted ports need
minimal care
