Mary Lou Garey MSN EMT-P MedFlight of Ohio

Size: px
Start display at page:

Download "Mary Lou Garey MSN EMT-P MedFlight of Ohio"

Transcription

1 Mary Lou Garey MSN EMT-P MedFlight of Ohio

2

3

4 Function Prolonged and frequent access to venous circulation Allows for patient to carry on normal life; decrease number of needle sticks Medications, parenteral nutrition, and blood transfusions can be administered

5 Function Inserted in central circulation where they remain for weeks or months Allows patients to be managed at home Can provide immediate venous access

6 Function Many types are in use. They consist of three catagories Central venous catheters (CVC) Implanted ports Peripherally inserted central catheters (PICC)

7 Description Most are constructed of radiopaque silicone Location of catheter will vary on patient patient preference, type and duration of therapy, and self / home care capabilities

8 The venous catheter is inserted with the tip in the superior vena cava just above the right atrium, thus the name of central venous catheter

9

10 Devices and insertion techniques Peripherally Inserted Central Catheters (PICC Lines) Subcutaneous Ports / Infusion Ports / Med Ports Hickman and Broviac Catheter

11 Peripherally Inserted Central Catheter Inserted through large peripheral veins

12 Best Suited for treatments lasting from several weeks to 6 months requiring frequent access to veins

13 Pros The least invasive of all the central lines Easily inserted and removed Relatively inexpensive Complications are usually minor Cons High maintenance (daily flushing) Often migrates Limits lifestyle somewhat Limited time frame of use

14 Insertion Sterile technique Bedside ultrasound insertion by a PICC RN Interventional radiology procedure using fluoroscopy or ultrasound

15 Ultrasound Insertion

16 Insertion Needle is inserted through a deep vein in the arm A wire is placed through the needle A dilator sheath is placed over the wire The catheter is threaded through the sheath

17 Insertion Chest X-rays are used to confirm that the tip is in the superior vena cava (SVC) just above the heart

18 Open end PICC lines Saline or Heparin used to keep line from clotting Closed end PICC lines (Groshong) Saline flush is all that is required to keep line from clotting

19 Care of the PICC Dressings changes by home health Rigorous arm activity discouraged PICC is flushed with saline or heparin / saline every day

20 Accessing a PICC line Flush with 10cc Normal Saline Aspirate for blood return

21 Always use a 10cc syringe If you meet resistance NEVER FORCE A FLUSH Re-attach flush to device and try a second time

22 Also known as MedPorts or infusion ports Plastic or titanium housing placed under the skin and connected to the vein via a tube. The port is a silicone disk that can withstand 2000 punctures

23 They can be single or double lumen

24 Pros Least maintenance Good for long term access (>6 months) Good for monthly chemotherapy Cons Most costly device Most time consuming to implant and explant

25 Pros Least maintenance Good for long term access (>6 months) Good for monthly chemotherapy Cons Most costly device Most time consuming to implant and explant

26 Insertion General anesthesia A pocket is made in the skin for the port A tunnel is made to connect the chest port to the tubing. Tubing is inserted into jugular to SVC

27

28 Insertion The port is then sutured or glued into the pocket and the skin incision is closed

29 Care Dressing is worn for one week Is not used for hours after insertion to minimize an infected blood clot Flush monthly and after each use with saline and heparin

30 Accessing a port A Huber Needle must always be used to access ports

31

32 Hickman Catheters Broviac Catheters Groshong Catheters It s only a name. they are all tunneled catheters. Groshong will not have clamps

33 A tunneled external catheter Single or duel lumen Used for Intermediate to long term use Frequent access High flow infusion and or infusion of blood products

34 Insertion General anesthesia Tunneled insertion of line The catheter is secured by glue or later the patient s own tissue growth The tip ends at the distal SVC above atrium

35 Broviac Catheter Cuff / Exit Sites

36 Accessing Aseptic technique Unclamp port being used (if not a Groshong product) Flush with 10cc saline Check for blood return Leurlock IV line into port

37 Caution Air emboli use the clamps on the catheter Thrombus Catheter shearing

38

39 Site Infection Pain Erythemia Swelling Drainage

40 Sepsis Elevated temp Tachycardia Weakness Body Aches Septic Shock

41 Thrombosis Sluggish fluid flow Swelling Local Tenderness Ecchymosis

42 Torn or leaking catheter Fluid extravasation Burning Local Tenderness Fluid Leaking Swelling

43 Air Embolysm Chest pain Shortness of breath Change in level of responsiveness Neurological deficit

44

45

46 Short line with two ports Placed in the femoral, subclavian, or internal jugular veins Used for temporary dialysis access

47 Caution High risk of emboli Must always aspirate prior any use Extremely high risk access site! Dialysis catheters are rarely accessed outside of the dialysis unit

48 Both ports end in same vessel Open ended catheters Instilled with high concentration heparin or a citrate solution after each dialysis to maintain patency Never flushed, but dwelling contents aspirated prior to use

49

50

51

52

53 Indications Cardiac Arrest Respiratory Compromise Hemodynamic Instability Bridge to Central Line Altered Level of Consciousness Difficult IV Placement

54

55 AHA; NAEMSP Guidelines IO should be considered early in vascular access emergencies ET tube is no longer recommended for drug delivery Central lines are discouraged

56 With pressure flow rates are similar to IV Tibial - 18 ga Humeral -16 ga

57 Contraindications Local Infection at insertion site Fractures in bone to be used Recent (24 hour) IO in same extremity Absence of anatomical landmarks or excessive tissue

58

59

60

61

62

63

64

65 Atropine Valium Digoxin Nitroglycerine Dopamine Dobutamine Amiodarone Phenergan

66

67

Unit 11. Objectives. Indications for IV Therapy. Intravenous Access Devices & Common IV Fluids. 3 categories. Maintenance Replacement Restoration

Unit 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 information

Central Line Care and Management

Central 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 information

You have a what, inside you?

You 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 information

You have a what, inside you?

You 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 information

Overview of CVADs. Type of device commonly used. Dwell time Flushing requirement Associated complications. lumens

Overview of CVADs. Type of device commonly used. Dwell time Flushing requirement Associated complications. lumens 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

More information

Central Venous Access Devices. Stephanie Cunningham Amy Waters

Central 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 information

IV 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. 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 information

IV Fluids. Nursing B23. Objectives. Serum Osmolality

IV 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 information

IV Fluids Nursing B23 Objectives Serum Osmolality 275 to 295 Isotonic

IV 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 information

Appendix E: Overview of Vascular

Appendix 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 information

IV Drug Delivery Systems used in Cancer Care

IV 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 information

1/22/2016. Disclaimer. Disclaimer

1/22/2016. 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 information

Vascu-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 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 information

Central Venous Catheter Care and Maintenance (includes catheter troubleshooting guide)

Central 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 information

Portacath Insertion. Patient Information Leaflet

Portacath 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 information

THE CARE AND MAINTENANCE OF TOTALLY IMPLANTED VENOUS ACCESS DEVICES (PORTS)

THE 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 information

Vascular 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 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 information

Procedures/Risks:central venous catheter

Procedures/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 information

Document No. BMB/IFU/40 Rev No. & Date 00 & 15/11/2017 Issue No & Date 01 & 15/11/2017

Document 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 information

Introduction to IV Therapy. BY Terry White, MBA, BSN

Introduction 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 information

Vaxcel Implantable Ports Valved and Non-Valved. A Patient s Guide

Vaxcel Implantable Ports Valved and Non-Valved. A Patient s Guide Vaxcel Implantable Ports Valved and Non-Valved A Patient s Guide Vaxcel Implantable Port This pamphlet provides some answers to questions you may have about your implantable port and how to care for it

More information

If 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  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 information

Intravenous Catheter Complications

Intravenous 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 information

Sierra Sacramento Valley EMS Agency Program Policy. Vascular Access

Sierra Sacramento Valley EMS Agency Program Policy. Vascular Access Sierra Sacramento Valley EMS Agency Program Policy Vascular Access Effective: 12/01/2017 Next Review: 09/2020 1101 Approval: Troy M. Falck, MD Medical Director Approval: Victoria Pinette Executive Director

More information

Children's (Pediatric) PICC Line Placement

Children'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 information

Per-Q-Cath* PICC Catheters with Excalibur Introducer* System

Per-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 information

COALINGA 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 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 information

Venous Access and Ports. Helen Starosta

Venous 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 information

Peel-Apart Percutaneous Introducer Kits for

Peel-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 information

Children s Acute Transport Service

Children 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 information

A Primer on Central Venous Access: Peripherally-Inserted Central Catheters, Tunneled Catheters, and Subcutaneous Ports

A 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 information

Curraheen, 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 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 information

CENTRAL VENOUS ACCESS DEVICES. BETHANY COLTON

CENTRAL 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 information

ompanionport Speciality Medical Devices For The Veterinary Community Surgical Suggestions

ompanionport Speciality Medical Devices For The Veterinary Community Surgical Suggestions Speciality Medical Devices For The Veterinary Community suture holes Place the CompanionPort in the subcutaneous port pocket off to one side so that the septum of the port will not lie directly beneath

More information

PORTS SETTING THE STANDARD WITH A COMPREHENSIVE FAMILY OF PORTS

PORTS SETTING THE STANDARD WITH A COMPREHENSIVE FAMILY OF PORTS PORTS SETTING THE STANDARD WITH A COMPREHENSIVE FAMILY OF PORTS As a single-source provider, Bard Access Systems sets the standard for implanted ports and vascular access devices. We make it possible for

More information

The 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 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 information

The University of Toledo Medical Center and its Medical Staff

The 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 information

Understanding your HICKMAN CATHETER

Understanding 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 information

Instructions For Use. Implantable Ports. with Open-Ended and Groshong Catheters

Instructions 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 information

Groshong* PICC and Catheters

Groshong* 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 information

Navigating Vascular Access Issues

Navigating 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 information

Advancing Lives and the Delivery of Health Care. The High-Flow Port Designed for Apheresis

Advancing Lives and the Delivery of Health Care. The High-Flow Port Designed for Apheresis Advancing Lives and the Delivery of Health Care The High-Flow Port Designed for Apheresis Optimized for Long Device Life Bench Tested up to 1,000 Accesses 1 Bard is proud to introduce the first and only

More information

Central venous access devices for children with lysosomal storage disorders

Central 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 information

External Ref: Andres, D.A., et al. Catheter Pinch-Off Syndrome: Recognition and Management.

External 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 information

IR Central Venous Access [ ] Pre Procedure

IR 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 information

Infusion Skills Competency Checklist To be used at annual skills fair or at any other time for IV Competency

Infusion 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 information

The C.L.O.T. Tool for Identifying Strategies to Prevent PICC Catheter Occlusions

The C.L.O.T. Tool for Identifying Strategies to Prevent PICC Catheter Occlusions The C.L.O.T. Tool for Identifying Strategies to Prevent PICC Catheter Occlusions page 2 TABLE OF CONTENTS Part 1: Definition and Scope of Catheter Occlusion Part 2: Predictors of Catheter Occlusion Part

More information

Ultrasound Guided Vascular Access. 7/25/2016

Ultrasound 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 information

1/22/2016. Objectives. Vascular Access Devices

1/22/2016. 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 information

PARENTERAL NUTRITION: VASCUAR ACCESS DEVICE SELECTION

PARENTERAL 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 information

Pediatric ER Half-day Rounds October 12, 2011 Dr. Karen Bailey

Pediatric ER Half-day Rounds October 12, 2011 Dr. Karen Bailey Pediatric ER Half-day Rounds October 12, 2011 Dr. Karen Bailey Objectives to identify various enteral and vascular access lines what do they look like? indications & contraindications proper placement

More information

Over the Wire Technique vs. Modified Seldinger Technique in Insertion of PICC

Over the Wire Technique vs. Modified Seldinger Technique in Insertion of PICC Over the Wire Technique vs. Modified Seldinger Technique in Insertion of PICC Deniz Kasikci Department of Radiology, Jena University Hospital Friedrich-Schiller-University, Jena, Germany Disclosure Speaker

More information

Port Design. Page 1. Port Placement, Removal, and Management. Selecting a Vascular Access Device. Thomas M. Vesely, MD

Port 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 information

If 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  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 information

Intraosseous Vascular Access. Dr Merl & Dr Veera

Intraosseous Vascular Access. Dr Merl & Dr Veera Intraosseous Vascular Access Dr Merl & Dr Veera INDICATIONS The EZ-IO can be used for adult and pediatric patients, Is indicated any time vascular access is difficult to obtain Can be in emergent, urgent,

More information

Dr. prakruthi Dept. of anaesthesiology, Rrmch, bangalore

Dr. 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

The High-Flow Port Designed & Indicated for Apheresis

The High-Flow Port Designed & Indicated for Apheresis The High-Flow Port Designed & Indicated for Apheresis Advancing Lives and the Delivery of Health Care Bard is proud to introduce the first and only high-flow, power-injectable port designed and indicated

More information

LONG-TERM HEMODIALYSIS CATHETER INSTRUCTIONS FOR USE

LONG-TERM HEMODIALYSIS CATHETER INSTRUCTIONS FOR USE LONG-TERM HEMODIALYSIS CATHETER INSTRUCTIONS FOR USE LONG-TERM HEMODIALYSIS CATHETER INSTRUCTIONS FOR USE INDICATIONS FOR USE: The Centros and CentrosFLO long-term hemodialysis catheter are indicated

More information

Vascular 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 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 information

Emergency clamp should always be readily available in case of accidental catheter fracture

Emergency 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 information

Research Article Can we predict the Position of Central Venous Catheter Tip Following Cannulation of Internal Jugular Vein?

Research Article Can we predict the Position of Central Venous Catheter Tip Following Cannulation of Internal Jugular Vein? Cronicon OPEN ACCESS ANAESTHESIA Research Article Can we predict the Position of Central Venous Catheter Tip Following Cannulation of Internal Jugular Vein? Pradeep Marur Venkategowda 1, Surath Manimala

More information

Central Venous Catheter Insertion: Assisting

Central 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 information

Polyurethane Catheter

Polyurethane Catheter References 1. Aitken, D.R. and Minton, J.P. The Pinch-Off Sign: A Subclavian Catheters, American Journal of Surgery, Vol. 148, Nov. 1984, pp. 633-636. 2. Rubenstein, R.B., Alberty, R.E., et al. Hickman

More information

Aspira* Peritoneal Drainage Catheter

Aspira* Peritoneal Drainage Catheter Aspira* Peritoneal Drainage Catheter Instructions For Use Access Systems Product Description: The Aspira* Peritoneal Drainage Catheter is a tunneled, long-term catheter used to drain accumulated fluid

More information

Peripherally Inserted Central Catheter & Midline Placement with ECG Confirmation of Tip Placement

Peripherally 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 information

SARASOTA MEMORIAL HOSPITAL NURSING PROCEDURE

SARASOTA MEMORIAL HOSPITAL NURSING PROCEDURE SARASOTA MEMORIAL HOSPITAL NURSING PROCEDURE TITLE: ISSUED FOR: IMPLANTED VASCULAR ACCESS DEVICE (IMPLANTED PORT) CARE AND MAINTENANCE Nursing DATE: REVIEWED: PAGES: RESPONSIBILITY: *RN, LPN II 09/84 2/18

More information

Dignity Dual Power Injectable Implantable Infusion Port INSTRUCTIONS FOR USE

Dignity Dual Power Injectable Implantable Infusion Port INSTRUCTIONS FOR USE DESCRIPTION: Dignity Dual Power Injectable Implantable Infusion Port INSTRUCTIONS FOR USE The Dignity Dual power injectable implantable infusion port is an implantable access device designed to provide

More information

NexSite HD, Hemodialysis Symmetric Tip Catheter for long term use. Directions for Use. Contents

NexSite HD, Hemodialysis Symmetric Tip Catheter for long term use. Directions for Use. Contents NexSite HD, Hemodialysis Symmetric Tip Catheter for long term use Directions for Use Contents Note to Physicians: Please consult the on-line training video on www.marvaomedical.com for information on the

More information

2018 HEMODIALYSIS CATHETERS CODING AND REIMBURSEMENT GUIDE

2018 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 information

Peripherally Inserted Central Catheter (PICC) Booklet

Peripherally 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 information

Complications Associated With IV Therapy

Complications 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 information

Totally indwelling venous access devices

Totally 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 information

PICC Care and Maintenance. Mary Lou Chaulk, RN

PICC 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 information

Education for Self Administration of Intravenous Therapy HOME IV THERAPY PICC. Portacath

Education 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 information

Vascular access in practice: best practice update

Vascular 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 information

Hemodialysis Catheters the good, the bad and the ugly. Elizabeth Evans DNP 9th Annual Southwest Nephrology Nursing Symposium

Hemodialysis Catheters the good, the bad and the ugly. Elizabeth Evans DNP 9th Annual Southwest Nephrology Nursing Symposium Hemodialysis Catheters the good, the bad and the ugly Elizabeth Evans DNP 9th Annual Southwest Nephrology Nursing Symposium No disclosures Objectives: 1. Discuss how scrub the hub prevents infection and

More information

Kristin Wise, MD, FHM Division of General Internal Medicine and Geriatrics Hospital Medicine 2013

Kristin Wise, MD, FHM Division of General Internal Medicine and Geriatrics Hospital Medicine 2013 Kristin Wise, MD, FHM Division of General Internal Medicine and Geriatrics Hospital Medicine 2013 Objectives for CVC Placement Understand the indications and contraindications Determine appropriate CVC

More information

MANAGEMENT OF INTRAVASCULAR (IV) LINES AND THERAPY. All GCC Countries

MANAGEMENT OF INTRAVASCULAR (IV) LINES AND THERAPY. All GCC Countries TITLE/DESCRIPTION: MANAGEMENT OF INTRAVASCULAR (IV) LINES AND THERAPY INDEX NUMBER: EFFECTIVE DATE: APPLIES TO: ISSUING AUTHORITY: 01/01/2009 01/01/2013 All GCC Countries GULF COOPERATION COUNCIL CENTRE

More information

ATI Skills Modules Checklist for Central Venous Access Devices

ATI 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 information

Groshong Central Venous Catheters

Groshong 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 information

Venepuncture and Cannulation. Louise Smith Clinical Nurse Specialist

Venepuncture 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 information

Aus Artificial Uretheral Sphincter Port System

Aus Artificial Uretheral Sphincter Port System NORFOLK VET PRODUCTS the AUS for the long-term relief of incontinence in dogs and cats making life easier for pets Speciality Medical Devices For The Veterinary Community the Aus Artificial Uretheral Sphincter

More information

Victoria Chapman BS, RN, HP (ASCP)

Victoria Chapman BS, RN, HP (ASCP) Victoria Chapman BS, RN, HP (ASCP) Considerations: Age Sex Body Composition Hydration Status Chemotherapy Use Access History Considerations: Immunosuppression Use Chemotherapy Frequency of plasma exchanges

More information

Insertion of a totally implantable vascular access device (TIVAD)

Insertion 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 information

ARROW ENDURANCE. Extended Dwell Peripheral Catheter System. Rx only.

ARROW ENDURANCE. Extended Dwell Peripheral Catheter System. Rx only. ARROW ENDURANCE Extended Dwell Peripheral Catheter System Rx only. Product Description: The ARROW Endurance catheter system is a sterile, single use peripheral intravascular device designed to permit access

More information

PRODUCTS FOR THE DIFFICULT AIRWAY. Courtesy of Cook Critical Care

PRODUCTS FOR THE DIFFICULT AIRWAY. Courtesy of Cook Critical Care PRODUCTS FOR THE DIFFICULT AIRWAY Courtesy of Cook Critical Care EMERGENCY CRICOTHYROTOMY Thyroid Cartilage Access Site Cricoid Cartilage Identify the cricothyroid membrane between the cricoid and thyroid

More information

IV Therapy January, 08 Tip of the Month

IV 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 information

IO considerations. Daniel Dunham

IO considerations. Daniel Dunham IO considerations Daniel Dunham If patient is conscious Advise of EMERGENT NEED for this procedure and obtain informed consent Rule out contraindications Fracture. Excessive tissue and/or absence of adequate

More information

APPENDIX EZ IO ADULT INTRAOSSEOUS INFUSION. Purpose: To establish guidelines for the insertion of an intraosseous catheter for patients > 40 kgs.

APPENDIX EZ IO ADULT INTRAOSSEOUS INFUSION. Purpose: To establish guidelines for the insertion of an intraosseous catheter for patients > 40 kgs. APPENDIX EZ IO ADULT INTRAOSSEOUS INFUSION Purpose: To establish guidelines for the insertion of an intraosseous catheter for patients > 40 kgs. Indications: Any Adult patient (>40 kg) for whom you are

More information

SARASOTA MEMORIAL HOSPITAL NURSING PROCEDURE

SARASOTA MEMORIAL HOSPITAL NURSING PROCEDURE SARASOTA MEMORIAL HOSPITAL NURSING PROCEDURE TITLE: TUNNELED CENTRAL VENOUS CATHETER CARE AND MAINTENANCE: HICKMAN, GROSHONG, POWERLINE, POWERHICKMAN DATE: REVIEWED: PAGES: 04/83 2/18 1 of 18 PS1094 ISSUED

More information

Central Venous Line Insertion

Central 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 information

Groshong Catheters with Introcan Safety Peripheral IV Catheter Introducer

Groshong 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 information

Stuck dialysis catheters. ANZSIN 2013 Michael Lam & Kendal Redmond

Stuck dialysis catheters. ANZSIN 2013 Michael Lam & Kendal Redmond Stuck dialysis catheters ANZSIN 2013 Michael Lam & Kendal Redmond NT 39 yr old CI Maori - ESKD 2 o to cortical necrosis HD August 2002 R IJ tunneled Tesio catheter Oct 2002 Failed L RC AVF Feb 2004 Failed

More information

Supplementary Material* Supplement. Appropriateness Criteria for Vascular Access in Hospitalized Patients

Supplementary Material* Supplement. Appropriateness Criteria for Vascular Access in Hospitalized Patients Supplementary Material* Chopra V, Flanders SA, Saint S, Woller SC, O'Grady NP, Safdar N, et al. The Michigan Guide for Intravenous Catheters (MAGIC): Results From a Multispecialty Panel Using the RAND/UCLA

More information

Choosing the right access for long term parenteral nutrition: PICC lines or tunnelled catheters G. Goossens (BE)

Choosing 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 information

PLASTIC POWER INJECTABLE IMPLANTABLE INFUSION PORT

PLASTIC POWER INJECTABLE IMPLANTABLE INFUSION PORT PLASTIC POWER INJECTABLE IMPLANTABLE INFUSION PORT INSTRUCTIONS FOR USE DESCRIPTION: The Power Injectable Implantable Infusion Port is an implantable access device designed to provide repeated access to

More information

EMS Subspecialty Certification Review Course. Conflict of Interest Disclosure. Learning Objectives

EMS Subspecialty Certification Review Course. Conflict of Interest Disclosure. Learning Objectives EMS Subspecialty Certification Review Course Cardiovascular 1.4.2.2 Placement of peripheral IV lines 1.4.2.2.1 Access or Placement of Central Venous Lines in the field 1.4.2.2.2 Intraosseous lines 1.4.2.2.3.

More information

Split-Stream LONG-TERM HEMODIALYSIS INSTRUCTIONS FOR USE

Split-Stream LONG-TERM HEMODIALYSIS INSTRUCTIONS FOR USE Split-Stream LONG-TERM HEMODIALYSIS INSTRUCTIONS FOR USE INDICATIONS FOR USE: INSTRUCTIONS FOR USE The Medcomp Split-Stream is indicated for use in attaining Long-Term vascular access for Hemodialysis

More information

The HeRO Graft. Shawn M. Gage, PA Division of Vascular Surgery Duke University Medical Center

The HeRO Graft. Shawn M. Gage, PA Division of Vascular Surgery Duke University Medical Center The HeRO Graft Shawn M. Gage, PA Division of Vascular Surgery Duke University Medical Center Faculty Disclosure I disclose the following financial relationships: CryoLife/Hemosphere, Inc. & W.L. Gore and

More information

The Power of Purple* Polyurethane PICC. Patient Guide. Access Systems

The 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 information