Peripheral Blood Draw/ CVAD Flashcards
(125 cards)
Peripheral Blood Draw Steps
Clean hands
Assess large vein (brachial)
Gloves
Position yourself in front of the vein
Tourniquet (4 inches above draw)
Syringe (let the air out)
Needle attach
Alcohol swab area
Anchor with angle/stick/ and slowly aspirate
With a butterfly - agitate the tubing when pulled out
Always release the tourniquet before removing the needle from vein
Cotton above entry site
Pull out and put pressure on the site
Cover needle
Put the needle into the 18-gauge tubing
- angled to the back wall but not touching
- Fill to label or desired label
Label the tubes before leaving the room
Sharps and trash designation
Peripheral Blood Draw Options
syringe/needle 18 gauge
vacuholder/needle
butterfly with vacuholder
washcloths/alcohol swabs/CHG/blood tubes(red tubes)/tourniquet/2x2/labels/2 hazard bags
CVAD Supplies
- 3 flushes
- empty 10 mL syringe
- blood fill needle
- lots of alcohol wipes
- gloves
- soap
Central Venous Access devices types
Tubing
Nontubing
Picc Line
Subclavian
CVAD Procedure with syringe technique
Wash hands
Towel under the tubing and skin
Access the area
Distal Lumen (Largest) is better to draw blood from
all Flush (purge the air, loosen cap)
wash hands with gloves
Unclamp distal lumen and clean with swab
Aspirate for blood return
-Pulse pause till 9 mL
- draw back 3-4 mL
-swab
- 10 mL syringe slow and steady 3-5 mL
-put blood fill needle into slow and steady blood
-swab
-flush with 19 mL (push pause)
Clean between
- Remove syringe
-Clamp
- Cap
CVAD Procedure with Safety Holder is only used on a
Subclavian or a Intrajugular
Never use a safety holder on a
PICC Line, too much pressure
CVAD Procedure with Safety Holder
- unclamp
- Clean for 15 sec
- dry
- aspirate air and flush
- pulse pause with 9 mL
- blood return of 3-4 mL
- take safety holder off, clean
- attached flush 19 mL (clean between flushes)
- swab cap
All lumens need to be flushed every
shift or 12 hours
Max 0 Needle-less connectors need to be changed every
7 days
-Clean, attached syringe to prime with saline flush ready
If the fluid is in the lumen,
discontinue or hold medications
The PICC line is commonly located in
the basilic or cephalic vein
CLABSI means
Central line-associated bloodstream infection
CVC Dressing Change Procedure
Tear from top
Open on the tearing arrows and open like an envelope
Clean the surface area and wait to dry
While drying = assess the area of the dressing
1) Wash hands and Don sterile gloves
2) Put on masks, and turn pt’s head to the other side, allergies to CHG
3) open alcohol sab to loosen dressing
4) 2nd packet - take out new sterile gloves
5) take the bottom border and unfold the back
6) Don sterile gloves
7) Supplies in order
- Core prep squeeze to clean site and allow to dry
- rapid dry skin barrier (like a painting, not center)
- apply dressing and line up
What is in the CVC Dressing Change Packet?
2 gloves (pt and nurse)
sterile gloves and hand sanitizer
alcohol swab
What is CLAPSI?
serious infection that occurs when germs (usually bacteria or viruses) enter the bloodstream through the central line
What is a CVAD / central line / central venous catheter?
an intravenous catheter (infusion port) that doctors often place in a large vein in the neck, chest, or groin to give medication or fluids or to collect blood for medical tests
Difference between central lines and IVs
central lines access a major vein that is close to the heart and can remain in place for weeks or months and be much more likely to cause serious infection
Central lines are commonly used in intensive care units.
Pts with CLAPSI have
fever
red skin
soreness around central line
What steps are taken to prevent CLAPSI?
o Perform hand hygiene
o Apply appropriate skin antiseptic
o Ensure that the skin prep agent has completely dried before inserting the central line
o Use all five maximal sterile barrier precautions:
Sterile gloves
Sterile gown
Cap
Mask
Large sterile drape
* Once the central line is in place:
o Follow recommended central line maintenance practices
o Wash their hands with soap and water or an alcohol-based handrub before and after touching the line
* Remove a central line as soon as it is no longer needed. The sooner a catheter is removed, the less likely the chance of infection.
What can Pts do to prevent CLAPSI?
- Speak up about any concerns so that healthcare personnel are reminded to follow the best infection prevention practices.
- Ask a healthcare provider if the central line is absolutely necessary. If so, ask them to help you understand the need for it and how long it will be in place.
- Pay attention to the bandage and the area around it. If the bandage comes off or if the bandage or area around it is wet or dirty, tell a healthcare worker right away.
- Don’t get the central line or the central line insertion site wet.
- Tell a healthcare worker if the area around the catheter is sore or red or if the patient has a fever or chills.
- Do not let any visitors touch the catheter or tubing.
- The patient should avoid touching the tubing as much as possible.
- In addition, everyone visiting the patient must wash their hands—before and after they visit.
PICC means
peripherally (vein) inserted central catheter
PICC line is a
radiopaque central venous access device (CVAD) that is usually inserted into the basilic or cephalic vein in the antecubital fossa and threaded up the vein until the tip of the catheter is in the cavoatrial junction
PICC lines are used for
administration of blood products, fluids, total parenteral nutrition and medications, as well as prolonged antibiotic therapy, and chemotherapy.