Overview of CVADs. Type of device commonly used. Dwell time Flushing requirement Associated complications. lumens
|
|
- Francis Norris
- 5 years ago
- Views:
Transcription
1 Source: Clinical Skills Management of Vascular Access Devices Pre-course handbook. Adapted with permission from NHS Lothian Employee and Education Development Team. Overview of CVADs Type of device Veins commonly used Design Number of lumens Dwell time Flushing requirement Associated complications Peripherally inserted central catheter (PICC) Basilic Cephalic Median Cubital 2 types Valved PICC has no external clamps. Open-ended non-valved has external clamps. Single or double Months up to a year 10ml luer lock syringe or greater. Pulsing action. For flushing solution please refer to local guidelines. Flushed once a week when the device is not in use. Phlebitis Infection Thrombosis Malposition Occlusion Non-tunneled central venous catheter (CVC) Internal jugular Subclavian Femoral Open-ended non-valved has external clamps. Single, double, triple, quad or quin days 10ml luer lock syringe or greater. For flushing solution please refer to local guidelines. Infection Thrombosis Occlusion Pneumothorax AR / AH / CC FINAL
2 Type of device Skin-tunneled catheter (Hickman / Broviac line) Veins commonly used Internal Jugular Subclavian Femoral Design Open-ended Valved Both have clamps externally Number of lumens Single, double, triple Dwell time Flushing requirement Associated complications Months to years 10ml luer lock syringe or greater. Pulsing action. Positive pressure. Flushed once a week when the device is not in use. For flushing solution please refer to local guidelines. Infection Thrombosis Occlusion Implanted port Internal Jugular Subclavian Femoral Open-ended Single or double Months to years 10ml luer lock syringe or greater. 4-6 weekly flush. Use Huber needle. For flushing solution Infection Thrombosis
3 please refer to local guidelines. Mid line Basilic Cephalic 10ml luer lock syringe or larger. Infection Occlusion Median Cubital For flushing solution please refer to local guidelines Dougherty, L. (2006) Central Venous Access Devices, Care and Management. Blackwell Publishing. Oxford.
4 POTENTIAL COMPLICATIONS There are a number of complications that can occur both during and as a result of the insertion of a central venous access device (CVAD). It is the nurse s responsibility to closely monitor the patient for signs of these complications [1] [2]. The complications listed below are those that you may come across in the community once the line is established. Full details of all complications would be discussed on a CVAD course. Potential complication The cause The signs The management Air embolus Caused by poor insertion technique by a lumen being open to air or potentially if a line is accidentally disconnected from the CVC lumen. It is potentially life-threatening as it can lead to cardiac arrest and death. [3] Respiratory distress Sudden collapse Breathlessness Chest pain Tachycardia Hypotension Seek medical help. Lie patient on left hand side and elevate foot of bed (to prevent air moving from right atrium into right ventricle then pulmonary circulation). Oxygen therapy. Chest x-ray. Infection Caused by poor insertion technique and CVAD management. Redness Swelling at site Pain Pyrexia Infected exudates from exit site Prevention and patient / parent education key. Swab site for bacteriology. Blood samples should also be taken for culture and sensitivity - from the CVAD and peripheral. Treatment as indicated. Possible catheter removal if sepsis unresolved following antibiotic AR / AH / CC FINAL
5 treatment. Potential complication The cause The signs The management CVAD Migration Occurs when the catheter moves from its original position, for example, if catheter is accidentally pulled. It is the nurse s role to check the position of the catheter at every use. Once in situ there should be adequate securement of the device both at the site and also of the external sets. Education of the patient and parent/carer to ensure that it is not pulled and report early if there are any changes to the length of the CVAD. Can be asymptomatic. Partial or complete catheter occlusion. Reduced infusion rate. Signs of extravasation (pain, breathlessness) Swelling of the chest wall. During insertion the position can be rectified. Ultrasound of the jugular vein can indicate malposition in the vessel before an X-ray. X-ray to confirm position of the tip of the CVAD. Line removed. Ear gurgling (described by patients when the CVAD has been positioned in the jugular vein).
6 CVAD Fracture Due to a faulty VAD set or through wear and tear. During insertion or as a result of the pinch off syndrome (when the catheter becomes trapped between the clavicle and the first rib) rubbing over time may cause the catheter to fracture and an embolism to occur. Not clamping at the correct position on the catheter. Nicking of the catheter when removing sutures. Over screwing of the cap on to the hub or not allowing the cleaning agent time to dry and effectively gluing the cap onto the hub which may cause the hub to crack. The VAD should be flushed and checked by the practitioner inserting VAD before insertion and the nurse should closely observe the catheter for leakage when it is in use. If there is any suspicion of a faulty VAD medical staff should be informed and the VAD removed and replaced. Catheter damage can occur at different points along the catheter. The catheter hub internal fracture. Above or below the catheter hub. The position of the catheter fracture will determine if the catheter can be repaired or needs removing. Prevention is key when caring for CVADs. Use 10ml or large syringes. Avoid the use of small syringes wherever possible. Monitor catheters for cuts, leaks or tears. Check the dressing for moisture or leakage at the insertion site during infusions. Educate the patient for signs. Immediate management is to clamp the catheter and assess the damage. Catheter repair can only be performed for external catheters. This should only be carried out by a skilled practitioner and in accordance with manufactures guidelines.
7 Datix incident completed and incident recorded in patient records. Thrombosis A thrombosis is a clot of blood that can be present at the tip of a catheter or can surround the catheter. An SVC (superior vena cava) thrombus is caused when the catheter rubs against the wall of the SVC and this provokes thrombosis at the site or a fibrin sheath. No blood return from the catheter. Reduce flow during infusions. Pain in the area. Oedema of the neck, chest and upper extremity. Tachycardia. Prevention: meticulous flushing with pulsatile positive pressure flush. Constant assessment of the function of the catheter. Venogram to diagnose Thrombolytic therapy (Urokinase). Oral anticoagulants. Catheter removal. Breathlessness. Cough. Discoloration of the limb. Catheter Occlusion There are two main types of occlusion: Persistent withdrawal occlusion (PWO) or total occlusion. PWO is when the catheter will flush but not bleed back preventing the practitioner from checking patency. Total occlusion is an inability to withdraw blood and infuse into the catheter. No withdrawal of blood from the catheter. The catheter may or may not flush. Prevention key: Correct flushing procedure Utilising a volumetric pump for infusion management; To ascertain the cause of the occlusion NB: Chemotherapy should NEVER be administered in a line with PWO
8 until the line has been checked by x- ray or venogram for position or signs of a blood clot or fibrin sheath at the end of the line. Written confirmation should then be documented in the patient s case notes to signify line is safe to use. If IV competent and competent in the management of central lines follow the algorithm for PWO as per unit policy. Routine care of Central Venous Access Devices (CVAD) / Specific advice Before caring for these lines training must have been completed and CVAD competencies achieved. Local policy should be followed when providing routine care to any CVAD. Regardless of the type of CVAD used the principles of care for the device remain the same [4]: To prevent infection To maintain a patent device To prevent damage to the device and associated equipment.
9 Skin Tunnelled Catheter (Hickman ) / Broviac line) Weekly flushes hepsal 10iu/ml to maintain patency when not in regular use. Weekly dressing change e.g. IV3000. Weekly bionector change. Do not get end of line(s) wet. Child or young person can shower with a central line once the exit site has healed however, should not direct the shower head directly at the line and soak it. Keep line in cotton bag provided or tape onto body when not in use to prevent accidental pulling. No swimming allowed, avoid contact sports. Implanted Port (Portacath ) Monthly flushes hepflush 100iu/ml to maintain patency when not in regular use. No dressing required when gripper needle not in situ. Gripper needle can stay in for seven days. Avoid contact sports.
10 Trouble shooting Potential problem Action Prevention Accidental removal of central line Cut or break in line Apply pressure with sterile swab at exit and entry site. Inform patient s treatment centre and advise patient to attend treatment centre. Clamp line above break to prevent bleeding. Cover break with a sterile swab or plaster. Seek advice from Paediatric Oncology Outreach Nurse Specialist (POONS) or treatment centre. Keep line in bag or tape onto body in a loop or S shape to prevent accidental pulling. Do not allow children to have scissors when line exposed. Clamp the line in a different place of the designated section every time.
11 References [1] Hamilton (2006) Complications associated with venous access devices: part two. Nursing Standard 20 (27): [2] Woodrow (2002) [3] Heckmann et al, 2000) [4] Royal College of nursing (RCN) (2010) Standards for Infusion Therapy. The RCN IV Therapy Forum.
12
Mary Lou Garey MSN EMT-P MedFlight of Ohio
Mary Lou Garey MSN EMT-P MedFlight of Ohio Function Prolonged and frequent access to venous circulation Allows for patient to carry on normal life; decrease number of needle sticks Medications, parenteral
More informationIV Fluids Nursing B23 Objectives Serum Osmolality 275 to 295 Isotonic
1 IV Fluids Nursing B23 2 Objectives 3 Serum Osmolality Serum osmolality solute concentration of a solution Higher osmolality means greater pulling power for water Normal serum osmolality is 275 to 295
More informationTHE CARE AND MAINTENANCE OF TOTALLY IMPLANTED VENOUS ACCESS DEVICES (PORTS)
Children s Hospital for Wales Department of Paediatric Respiratory Medicine and Cystic Fibrosis THE CARE AND MAINTENANCE OF TOTALLY IMPLANTED VENOUS ACCESS DEVICES (PORTS) This protocol applies to the
More informationIV Fluids. Nursing B23. Objectives. Serum Osmolality
IV Fluids Nursing B23 Objectives Discuss the purpose of IV Discuss nursing interventions in IV therapy Identify complications of IV therapy Differentiate between peripheral line, central line, and PICC
More informationCurraheen, Co. Cork. Guidelines on the Management and Care of Central Venous Access Devices
Curraheen, Co. Cork. Guidelines on the Management and Care of Central Venous Access Devices Date re-approved: 27 th Jan 2015. Version No: 2 Revision Due: 2018 Index code: CLIN028 Disclaimer: The information
More informationYou have a what, inside you?
Costal Emergency Medicine Conference You have a what, inside you? Less than mainstream medical devices encountered in the ED. Eric Ossmann, MD, FACEP Associate Professor Duke University Medical Center
More informationThe Impact of Catheter Occlusion in Central Line Associated Bloodstream Infections M A R C H 15, 2017
The Impact of Catheter Occlusion in Central Line Associated Bloodstream Infections D A R C Y DOELLMAN M S N, RN, CRNI, VA - BC M A R C H 15, 2017 LOUISVILLE, KENTUCKY Cincinnati Children s Hospital 642
More informationVascular access device selection & placement. Alisa Seangleulur, MD Anesthesiology Department, Faculty of Medicine, Thammasat University
Vascular access device selection & placement Alisa Seangleulur, MD Anesthesiology Department, Faculty of Medicine, Thammasat University How to make the right choice of vascular access device.. Peripheral
More informationIntravenous Catheter Complications
Vascular Access Device-Related Infection Inadequate skin antisepsis prior to VAD insertion Acute onset of fever, chills, and hypotension. No other apparent source of Notify Prescriber immediately Obtain
More informationCentral Line Care and Management
Central Line Care and Management What is a Central Line/ CVAD? (central venous access device) A vascular infusion device that terminates at or close to the heart or in one of the great vessels (aorta,
More informationYou have a what, inside you?
Costal Emergency Medicine Conference You have a what, inside you? Less than mainstream medical devices encountered in the ED. Eric Ossmann, MD, FACEP Associate Professor Duke University Medical Center
More informationCENTRAL VENOUS ACCESS DEVICES. BETHANY COLTON
CENTRAL VENOUS ACCESS DEVICES. BETHANY COLTON Aims and Objectives To know what central venous access devices (CVAD) are. Types of CVADS used in haematology. To understand why we use them To know the complications
More informationPeripherally Inserted Central Catheter (PICC) Booklet
Aintree University Hospital FT PICC Booklet: a real world example This local booklet is an example used in the NICE medical technology guidance adoption support resource for SecurAcath for securing percutaneous
More informationPortacath Insertion. Patient Information Leaflet
Portacath Insertion Patient Information Leaflet What is a Portacath? A Portacath (also referred to as Port, Chemoport or Power Port) is an implanted central venous access device (CVAD) recommended for
More informationProcedures/Risks:central venous catheter
Procedures/Risks:central venous catheter Central Venous Catheter Placement Procedure: Placement of the central venous catheter will take place in the Interventional Radiology Department (IRD) at The Ohio
More informationExternal Ref: Andres, D.A., et al. Catheter Pinch-Off Syndrome: Recognition and Management.
Department Policy Code: D: PC-5530 Entity: Fairview Pharmacy Services Department: Fairview Home Infusion Manual: Policy and Procedure Manual Category: Home Infusion Subject: Complications With Intravenous
More informationIf viewing a printed copy of this policy, please note it could be expired. Got to to view current policies.
If viewing a printed copy of this policy, please note it could be expired. Got to www.fairview.org/fhipolicies to view current policies. Department Policy Code: D: PC-5530 Entity: Fairview Pharmacy Services
More informationPer-Q-Cath* PICC Catheters with Excalibur Introducer* System
Bard Access Systems Per-Q-Cath* PICC and Catheters with Excalibur Introducer* System Instructions For Use Table of Contents Table of Contents Page Contents 1 Product Description, Indications & Contraindications
More informationValue Life Lifecath Midli n e uide to Lifecath Midline rse s G u N A
Value Life Lifecath Midl ine A Nurse s Guide to Lifecath Midline www.vygon.co.uk vygon@vygon.co.uk Useful Information Lifecath Midline Lifecath Midline Catheter Code: 1296 Peelable Cannula Introducer
More informationCentral venous access devices for children with lysosomal storage disorders
Great Ormond Street Hospital for Children NHS Foundation Trust: Information for Families Central venous access devices for children with lysosomal storage disorders This information explains about central
More informationVenepuncture and Cannulation. Louise Smith Clinical Nurse Specialist
Venepuncture and Cannulation Louise Smith Clinical Nurse Specialist Outcomes By the end of this session you will be aware of: Basic anatomy Preparation procedures including patient identification Equipment
More informationUnderstanding your HICKMAN CATHETER
Understanding your HICKMAN CATHETER Patient Information What is the purpose of this information sheet? This information sheet has been written by patients, members of the public and health professionals.
More informationComplications Associated With IV Therapy
Occlusion is the partial or complete obstruction of a catheter, which obstructs the infusion of solutions or medications. Occlusions can result from the coagulation of blood (thrombotic) or from obstruction
More informationPeel-Apart Percutaneous Introducer Kits for
Bard Access Systems Peel-Apart Percutaneous Introducer Kits for Table of Contents Contents Page Bard Implanted Ports Hickman*, Leonard*, Broviac*, Tenckhoff*, and Groshong* Catheters Introduction....................................
More informationEmergency clamp should always be readily available in case of accidental catheter fracture
Note: Please see individual policies for further information. Flushing best practice: Always use a 10 diameter syringe or larger when first accessing and when flushing vascular access device (VAD) Use
More informationPICC Care and Maintenance. Mary Lou Chaulk, RN
PICC Care and Maintenance Mary Lou Chaulk, RN Types: Valved: Bard - Groshong - valve at distal tip -Solo - valve at proximal hub - Power PICC Angio Dynamic (Navilyst) - Vaxcel -Xcela (Power PICC) - Bioflo
More informationCentral Venous Catheter Care and Maintenance (includes catheter troubleshooting guide)
Central Venous Catheter Care and Maintenance (includes catheter troubleshooting guide) A Guide for Patients in the Home Phone Number: Nurse/Contact: Central Venous Catheters This manual is a guide for
More informationEducation for Self Administration of Intravenous Therapy HOME IV THERAPY PICC. Portacath
HOME IV THERAPY PICC Portacath Who To contact Cardio-Respiratory Integrated Specialist Services (CRISS) Office hours 0800 1630 hours Ph: 364 0167 Weekends and after hours, phone Christchurch Hospital operator
More informationNetwork Policy for the Care and Management of Central Venous Access Devices (CVAD) in Adults.
Network Policy for the Care and Management of Central Venous Access Devices (CVAD) in Adults. Quality and safety for every patient every time Document Control Prepared By Sharon Harper Wendy Anderson Issue
More informationInsertion of a totally implantable vascular access device (TIVAD)
Insertion of a totally implantable vascular access device (TIVAD) What is a TIVAD? A TIVAD is a long hollow tube that is inserted into one of the large veins in your body. One end of the tube sits in a
More informationCentral Venous Access Devices. Stephanie Cunningham Amy Waters
Central Venous Access Devices Stephanie Cunningham Amy Waters 5 Must Know Facts About CVAD s 1) What are CVAD s? 2) What are CVAD s used for? 3) How are these devices put in? 4) What are the complications
More informationTotally indwelling venous access devices
Totally indwelling venous access devices Leeds MDT. April, 2008. Totally indwelling venous access devices [online]. Department of Respiratory Medicine, St James's University Hospital, UK. Available from
More informationCOALINGA STATE HOSPITAL NURSING POLICY AND PROCEDURE MANUAL SECTION Treatments POLICY NUMBER: 428. Effective Date: August 31, 2006
COALINGA STATE HOSPITAL NURSING POLICY AND PROCEDURE MANUAL SECTION Treatments POLICY NUMBER: 428 Effective Date: August 31, 2006 SUBJECT: CENTRAL VASCULAR ACCESS DEVICES (CVADs): CARE AND USE 1. PURPOSE:
More informationPATIENT CARE PLAN FOR CARE OF PERIPHERAL MIDLINE. Manufacturers specific recommendations should be noted and adhered to by individual practitioners.
PATIENT CARE PLAN FOR CARE OF PERIPHERAL MIDLINE The care plan is designed to be used in conjunction with CINS Guidelines for vascular devices. Manufacturers specific recommendations should be noted and
More informationIf viewing a printed copy of this policy, please note it could be expired. Got to to view current policies.
If viewing a printed copy of this policy, please note it could be expired. Got to www.fairview.org/fhipolicies to view current policies. Department Policy Code: D: PC-5555 Entity: Fairview Pharmacy Services
More informationCentral Venous Catheter Insertion: Assisting
Approved by: Central Venous Catheter Insertion: Assisting Gail Cameron Senior Director, Operations, Maternal, Neonatal & Child Health Programs Dr. Santiago Ensenat Medical Director, Neonatology Neonatal
More informationThe University of Toledo Medical Center and its Medical Staff
Name of Policy: Policy Number: Department: 3364-109-GEN-705 Infection Control Medical Staff Hospital Administration Approving Officer: Responsible Agent: Scope: Chair, Infection Control Committee Chief
More informationPARENTERAL NUTRITION: VASCUAR ACCESS DEVICE SELECTION
PARENTERAL NUTRITION: VASCUAR ACCESS DEVICE SELECTION Winifred Magambo-Gasana Vascular Access Nurse Practitioner Oxford University Hospitals NHS Foundation Trust Aim An overview of the range of Vascular
More informationATI Skills Modules Checklist for Central Venous Access Devices
For faculty use only Educator s name Score Date ATI Skills Modules Checklist for Central Venous Access Devices Student s name Date Verify order Patient record Assess for procedure need Identify, gather,
More informationVascular access in practice: best practice update
Vascular access in practice: best practice update Nicola York Clinical Nurse Manager Vascular Access Oxford University Hospitals NHS Foundation Trust June 2016 Objectives Patient assessment Best practice
More informationIV Drug Delivery Systems used in Cancer Care
IV Drug Delivery Systems used in Cancer Care Cheri Constantino-Shor, RN, MSN, CRNI Seattle Cancer Care Alliance Nursing Staff Development Coordinator Presentation Objective Describe drug delivery devices
More informationAdult Venous Access Policy including the Care and Management Central Venous Access Devices (CVADs)
Adult Venous Access Policy including the Care and Management Central Venous Access Devices (CVADs) Quality and safety for every patient every time Document Control Prepared By Sharon Harper Wendy Anderson
More informationGroshong* PICC and Catheters
Bard Access Systems Groshong* PICC and Catheters Instructions For Use Table of Contents Table of Contents Page Contents 1 Product Description 2 Product Description, Indications & Contraindications 3 Contraindications,
More informationPLEASE FOLLOW STEP BY STEP GUIDE ENCLOSED. FLUSH WEEKLY WITH SALINE AND CLEAN SITE WEEKLY WITH CHLORAPREPP : chlorhexidine 2% in 70% alcohol.
South Wales Intravenous Access Advisory Group Guidelines for the care and maintenance of a Tunnelled Cuffed Catheter (TCC) e.g. Hickman, Broviac PLEASE FOLLOW STEP BY STEP GUIDE ENCLOSED. FLUSH WEEKLY
More informationTOTALLY IMPLANTED VENOUS ACCESS DEVICES
Information for Parents/Carers TOTALLY IMPLANTED VENOUS ACCESS DEVICES This leaflet tells you about having a totally implanted venous access device (Port). It explains what is involved and what the benefits
More informationVascu-PICC WITH CUFF PERIPHERALLY INSERTED CENTRAL VEIN ACCESS CATHETER INSTRUCTIONS FOR USE
Vascu-PICC WITH CUFF PERIPHERALLY INSERTED CENTRAL VEIN ACCESS CATHETER INSTRUCTIONS FOR USE INDICATIONS FOR USE: The Vascu-PICC with cuff Peripherally Inserted Central Vein Catheters are designed for
More informationUpdated version of the South Wales Intravenous Access Advisory Group
Updated version of the South Wales Intravenous Access Advisory Group Guidelines for the care and maintenance of a Tunnelled Cuffed Catheter (TCC) e.g. Hickman, Broviac PLEASE FOLLOW STEP BY STEP GUIDE
More informationIV therapy. By: Susan Mberenga, RN, MSN. Copyright 2016, 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.
IV therapy By: Susan Mberenga, RN, MSN 1 IV Therapy Types of solutions Isotonic Hypotonic Hypertonic Caution: Too rapid or excessive infusion of any IV fluid has the potential to cause serious problems
More informationSkin tunnelled dialysis catheter (Tesio ) insertion
Skin tunnelled dialysis catheter (Tesio ) insertion This leaflet explains more about Tesio insertion, including the benefits, risks and any alternatives and what you can expect when you come to hospital.
More informationFLEXIC ATH LTD. Peripherally Inserted. Instructions n For Use.
FLEXIC ATH LTD * M/29M Peripherally Inserted Catheter Instructions n For Use This leaflet contains instructions for both stan- dard needle-introducer er and protection con- tained M/29 models, i.e., with
More information1/22/2016. Disclaimer. Disclaimer
Disclaimer Omnicare, Inc., as a provider of Infusion Pharmacy Services, is committed to the establishment and maintenance of the highest quality of care in infusion therapy services. This Infusion Therapy
More informationChildren's (Pediatric) PICC Line Placement
Scan for mobile link. Children's (Pediatric) PICC Line Placement A peripherally inserted central catheter (PICC line) is most often used to deliver medication over a long period. The doctor or nurse inserts
More informationCentral Venous Line Insertion
Central Venous Line Insertion Understand the indications and risks of CVC insertion Understand and troubleshoot the seldinger technique Understand available sites and select the appropriate site for clinical
More informationHemodialysis Catheter What is Hemodialysis Catheter?
Hemodialysis Catheter What is Hemodialysis Catheter? Hemodialysis is a treatment to replace the function of your kidneys when they are failed. In the process of hemodialysis, your own blood will be drawn
More informationRESTORING PATENCY TO CENTRAL VENOUS ACCESS DEVICES
RESTORING PATENCY TO CENTRAL VENOUS ACCESS DEVICES Indications Venous access is poor Intravenous therapy involves venous sclerosants Ambulatory chemotherapy given as an outpatient Repeated sampling, or
More informationNavigating Vascular Access Issues
Navigating Vascular Access Issues The Oley Foundation 27 th Annual Consumer/Clinician Conference Redondo Beach, CA June, 27 2012 Anita Piano, BS, RN, VA-BC Administrative Nurse, PICC Service UCLA Health
More informationIV Therapy January, 08 Tip of the Month
Every Hub Every Time IV Therapy January, 08 Tip of the Month Every Hub Every Time No matter what the occasion, SCRUB the catheter ports every single time before access. Evidence Supports SCRUBBING using
More informationA Primer on Central Venous Access: Peripherally-Inserted Central Catheters, Tunneled Catheters, and Subcutaneous Ports
Disclosures A Primer on Central Venous Access: Peripherally-Inserted Central Catheters, Tunneled Catheters, and Subcutaneous Ports No conflicts of interest relevant to this presentation Jason W. Pinchot,
More information2018 HEMODIALYSIS CATHETERS CODING AND REIMBURSEMENT GUIDE
2018 HEMODIALYSIS CATHETERS CODING AND REIMBURSEMENT GUIDE Contents Overview of Central Venous Access s for Hemodialysis 2 Procedures Using Hemodialysis s 2 Physician Reimbursement for Hemodialysis s 3
More informationIntroduction to IV Therapy. BY Terry White, MBA, BSN
Introduction to IV Therapy BY Terry White, MBA, BSN Important It is West Virginia State Law that nursing students (LPN and RN) are forbidden to start IVs or draw blood samples on patients Taking this class
More information2. Indications Infusion of hyperosmolar medication, e.g. TPN. Administration of vasoactive/irritant drugs.
Policy and Procedure for Insertion and care of Peripherally Inserted Central Catheters by Neonatal Staff (see Ch 8 TPN) 1. Introduction The peripherally inserted central catheter (PICC) is an intravenous
More informationCENTRAL VENOUS CATHETER (CVC) - BASIC CARE AND MAINTENANCE ADULT
POLICY Principles for Care The recommended and optimal CVC tip position is the distal (lower third) superior vena cava (SVC) and the cavo atrial junction. Physician orders are required for the following
More informationNOTTINGHAM CHILDREN S HOSPITAL Nursing Guideline. P07 Care and Management of Children with a Totally Implantable Venous Access Device (Portacath).
NOTTINGHAM CHILDREN S HOSPITAL Nursing Guideline P07 Care and Management of Children with a Totally Implantable Venous Access Device (Portacath). Introduction A Portacath is a central venous access device
More informationChildren s Acute Transport Service
Children s Acute Transport Service Vascular Access Document Control Information Author Ramnarayan Author Position Consultant, CATS Document Owner Polke Document Owner Position CATS Co-ordinator Document
More information1/22/2016. Objectives. Vascular Access Devices
Objectives 1. Discuss selection of appropriate vascular access device based on type and duration of prescribed therapy 2. Demonstrate correct procedure for short peripheral IV insertion including: preparation
More informationInfusion Skills Competency Checklist To be used at annual skills fair or at any other time for IV Competency
Employee Profile Infusion Skills Checklist Last Name First Name Middle Initial Employee Number Employee Discipline Check one: RN LPN Per state specific LPN Practice Acts Direct Supervisor s Name: Date
More informationChoosing the right access for long term parenteral nutrition: PICC lines or tunnelled catheters G. Goossens (BE)
ESPEN Congress Lisbon 2015 HOW TO MAKE HOME PARENTERAL NUTRITION SAFER Choosing the right access for long term parenteral nutrition: PICC lines or tunnelled catheters G. Goossens (BE) Choosing the right
More informationVascular Devices Pre-Existing. Jamla Bergman, MSN, RN, EMT Christopher J. Fullagar, MD, EMT-P, FACEP Stan Goettel, MS, EMT-P
Vascular Devices Pre-Existing Jamla Bergman, MSN, RN, EMT Christopher J. Fullagar, MD, EMT-P, FACEP Stan Goettel, MS, EMT-P Author credits / conflict declaration No financial conflicts of interest 2 Content
More informationPort Design. Page 1. Port Placement, Removal, and Management. Selecting a Vascular Access Device. Thomas M. Vesely, MD
Non-Dialysis Procedures Port Placement, Removal, and Management Thomas M. Vesely, MD Saint Louis, Missouri Selecting a Vascular Access Device Duration of use Number of lumens Frequency used Blood flow
More informationInsertion of a Haemodialysis Catheter
Insertion of a Haemodialysis Catheter Exceptional healthcare, personally delivered Introduction This leaflet is about the procedure required to put in a temporary dialysis catheter. It is intended to give
More informationUltrasound Guided Vascular Access. 7/25/2016
Ultrasound Guided Vascular Access 7/25/2016 www.ezono.com 1 Objectives Indications for insertion of central and peripheral lines Complications associated with procedures Role of ultrasound in vascular
More informationRadiology Polyurethane Catheter
Radiology Polyurethane Catheter with Microintroducer Revised date: January 2018 Bard, PowerPICC, Provena and StatLock are trademarks and/or registered trademarks of C. R. Bard, Inc. All other trademarks
More informationPrevention of thrombosis
Prevention of thrombosis Massimo Lamperti MD, MBA Chief of General Anaesthesia Department Anaesthesiology Institute Cleveland Clinic Abu Dhabi Clinical Professor of Anaesthesiology Cleveland Clinic Lerner
More informationComplications of Central Vascular Access Devices
Complications of Central Vascular Access Devices Central vascular access devices, or central venous access devices (CVADs), are fundamental in the nursing care of the critically ill, those with chronic
More informationThe Power of Purple* Polyurethane PICC. Patient Guide. Access Systems
The Power of Purple* Polyurethane PICC Patient Guide Access Systems Preamble Your doctor is giving you a PowerPICC* catheter so that you can easily get the intravenous (IV) medicines you need. This catheter
More informationTitle: Greater Manchester and Cheshire Cancer Network Policy for the Care of long term Central Venous Catheters
Title: Greater Manchester and Cheshire Cancer Network Policy for the Care of long term Central Venous Catheters Purpose: For staff to be aware of policies and guidelines for the care of long term Central
More informationCentral venous access devices. A guide for patients receiving intravenous therapies
Central venous access devices A guide for patients receiving intravenous therapies i Central venous access devices Contents Introduction 1 What is a central venous access device (CVAD)? 1 What are the
More informationGroshong Catheters with Introcan Safety Peripheral IV Catheter Introducer
Bard Access Systems Groshong Catheters with Introcan Safety Peripheral IV Catheter Introducer Instructions For Use Table of Contents Table of Contents Page Contents 1 Product Description 2 Product Description,
More informationModule 10 Troubleshooting Guide
Module 10 Troubleshooting Guide Your safety and wellbeing are our priority. Issues can occur during your treatment and it is important that you recognize the symptoms. This guide will teach you how to
More informationPeripherally Inserted Central Catheter & Midline Placement with ECG Confirmation of Tip Placement
Title/Description: Peripherally Inserted Central Catheter & Midline Placement with ECG Confirmation of Tip Placement Department: Patient Care Services Personnel: Nursing Services Effective Date: April
More informationPROCEDURE FOR THE CARE AND MAINTENANCE OF CENTRAL INTRAVENOUS ACCESS DEVICES
PROCEDURE FOR THE CARE AND MAINTENANCE OF CENTRAL INTRAVENOUS ACCESS DEVICES First Issued Issue Version Purpose of Issue/Description of Change Planned Review Date One To ensure a safe and effective procedure
More informationIV Catheter Placement
Year Group: BVSc3 + Document number: CSL_A06 Equipment for this station: Equipment list: IV catheter model, with giving set and red fluid bag IV catheter Bung or T-port Tape two strips cut to size before
More informationPolyurethane Radiology PICC
Polyurethane Radiology PICC with Microintroducer Revised date: February 2016 Bard, PowerPICC, StatLock, and The Power of Purple are trademarks and/or registered trademarks of C. R. Bard, Inc. All other
More informationIs it Necessary to Verify Blood Return in Monthly Port Flushes?
Is it Necessary to Verify Blood Return in Monthly Port Flushes? Gloria B. Ascoli, RN, CRNI, Amy C. Brown, BSN, RN, Jessica L. Cooper, BSN, RN, Allison N. Crawford, BSN, RN, CRNI Background Research Aims
More informationAdult Vascular Access Policy
Adult Vascular Access Policy Lead Manager: Margaret Connolly Responsible Director: David Stewart Approved by: GGC Clinical Governance Group Date approved: Date: Updated November 2014 Date for Review: Date:
More informationAPN Fong So Kwan Haematology & HSCT unit Medical Department, QMH
APN Fong So Kwan Haematology & HSCT unit Medical Department, QMH 1 WHAT IS CVAD? Central venous access device (CVAD) tunneled catheters intended for long-term access inserted into the superior or inferior
More informationAppendix E: Overview of Vascular
Appendix E: Overview of Vascular 56 Peripheral Short Catheter, less than 3 inches (7.5 cm) in length; over-the-needle catheter is most common. Inserted by percutaneous venipuncture, generally into a hand
More informationBPG 03: Continuous Renal Replacement Therapy (CRRT)
BPG 03: Continuous Renal Replacement Therapy (CRRT) Statement of Best Practice Patient s requiring Continuous Renal Replacement Therapy (CRRT) will receive appropriate therapy to meet their individual
More informationVenous Access and Ports. Helen Starosta
Venous Access and Ports Helen Starosta Venous access and ports Peripheral IV access Arterio-Venous Fistula Central venous access Peripherally Inserted Central Catheter (PICC) Non Tunnelled Central Venous
More informationUnit 11. Objectives. Indications for IV Therapy. Intravenous Access Devices & Common IV Fluids. 3 categories. Maintenance Replacement Restoration
Unit 11 Fluids, Electrolytes and Acid Base Imbalances Intravenous Access Devices & Common IV Fluids Objectives Review the purpose and types of intravenous (IV) therapy. Recall the nursing care related
More informationGroshong Central Venous Catheters
Bard Access Systems Groshong Central Venous Catheters Long Term Instructions For Use Table of Contents Contents Page Introduction... 1 Description Placement Schematics Groshong Valve Function Indications
More informationUpper Extremity Venous Duplex. Michigan Sonographers Society Fall Ultrasound Symposium October 15, 2016
Upper Extremity Venous Duplex Michigan Sonographers Society Fall Ultrasound Symposium October 15, 2016 Patricia A. (Tish) Poe, BA RVT FSVU Director of Quality Assurance Navix Diagnostix Patricia A. Poe
More informationBARD. Instructions For Use
BARD Instructions For Use 1 Product Description PowerMidline Catheters are a family of peripherally placed catheters made from radiopaque body-softening polyurethane materials. Each PowerMidline Catheter
More informationIdentification and Management of Central Vascular Access Device Complications
Identification and Management of Central Vascular Access Device Complications David Hahn, MD Interventional Radiology NorthShore University HealthSystem Evanston, Illinois Disclosures Consultant, AngioDynamics,
More informationDocument No. BMB/IFU/40 Rev No. & Date 00 & 15/11/2017 Issue No & Date 01 & 15/11/2017
Central Venous Catheter Device Description Multi-lumen catheters incorporate separate, non-communicating vascular access lumens within a single catheter body. Minipunctur Access Sets And Trays: Used for
More informationInstructions For Use. Implantable Ports. with Open-Ended and Groshong Catheters
Instructions For Use Implantable Ports with Open-Ended and Groshong Catheters 3 Implantable Ports with Open-Ended and Groshong Catheters 1 Description The BardPort, SlimPort, and X-Port implantable ports
More informationCarry this card with you at all times. Show this card to any medical professional treating you. Patient Implant Card. Option ELITE Vena Cava Filter.
Patient Guide A Safe Option for a Healthier You! P/N: P-2017-0175-00 Rev B 1. Static magnetic field of 3 Tesla or less. 2. Spatial gradient magnetic field of 720 Gauss/cm or less. 3. Maximum whole body
More informationGUIDELINE FOR CLINICAL STAFF ON: HICKMAN / BROVIAC CATHETER IN OLCHC
GUIDELINE FOR CLINICAL STAFF ON: HICKMAN / BROVIAC CATHETER IN OLCHC Version Number Date of Issue Reference Number Review Interval Approved By Name: Fionnuala O Neill Title: Nurse Practice Coordinator
More informationIR Central Venous Access [ ] Pre Procedure
IR Central Venous Access [1050200001] Pre Procedure Case Request/Scheduling Procedure Enter IR Case Request if not already completed (All hospitals except Grant Medical Center) [ ] Case Request IR Lab
More informationDr. prakruthi Dept. of anaesthesiology, Rrmch, bangalore
CENTRAL VENOUS CATHETERIZATION Dr. prakruthi Dept. of anaesthesiology, Rrmch, bangalore OBJECTIVES Introduction Indications and Contraindications Complications Technique Basic principles Specifics by Site
More information