COMPLEX LINES

Question 1

What is the difference between a peripherally inserted central line (PICC) and a central line (CVC)?

Answer 1

A PICC line is a thin flexible tube that is inserted into a vein normally in the upper arm and threaded into the superior vena cava. Access is peripheral
- Remain insitu for 1.5 days
- Higher risk of infection

CVC is inserted into a large central vein and advanced until the terminal lumen resides within the inferior vena cava, superior vena cava or right atrium.
- Remain insitu for 4x longer than PICC
- Lower fatality rate

Question 2

What are the common insertion sites for a PICC and a CVC?

Answer 2

PICC → large veins in upper arm e.g. brachial vein
CVC → internal jugular vein, subclavian vein and femoral vein

Question 3

What is the indication of use for a PICC and CVC?

Answer 3

PICC → A long-term access catheter that is inserted intravenously into either the cephalic, brachial or femoral vein (increased risk of thrombosis and infection). Indications include administration of chemotherapy medication, and antibiotic therapy.

PICC line complications → pneumothorax, vessel perforation during insertion and infection

CVC → A long-term catheter that is inserted intravenously into the internal jugular vein, subclavian vein or axillary vein). Indications include administration of medication or fluids that are unable to be administered by mouth.

CVC complications → bleeding, infection/sepsis, air embolism, hypothermia, arrhythmias

Question 4

What is an arterial line and what is its indication for use?

Answer 4

A catheter that is inserted into the artery to monitor real-time blood pressure.
- Continuous and accurate
- Insertion - radial and femoral artery
Indication - unstable patients, hypo/hypertension, frequent ABGs

Question 5

Complications of Arterial lines?

Answer 5

Air embolism
Haemorrhage
Thrombosis
Infection/sepsis
Incorrect insertion

Question 6

Identify nursing responsibilities in caring for PICCs, CVCs + Artline’s

Answer 6

→ Cardiac monitoring/patient observations (ECG)
→ Get patient consent
→ Explain procedure, indication and complications to patient
→ Securing central line
→ infection control
→ Documentation including location of insertion