CVAD Flashcards
Most Common Types of CVADs
Peripherally Inserted Central Catheter (PICC)
Double, Triple, and Quad Lumen Non-Tunneled
Port-A-Cath
Tunneled Catheter (also known as Hickman or Broviac catheters)
Peripherally Inserted Central Catheter (PICC)
Placed in peripheral vein just above ___ and terminates in ___
Can be placed by:
Can be (how long):
AC
SVC
MD, provider (PA or NP), or specialized RN
short-term, mid-term, or long-term line (maximum is typically around a year)
Non-Tunneled Lines: Single, Double, Triple, or Quad Lumen
Typically placed in ___ or ____ and terminates in ___
Used in ____ situations
Can be placed quickly
___-term line
IJ or SCL (subclavian)
SVC
emergent/acute
Short
Port-A-Cath
Placed underneath the ____ with a line terminating in the ____
Port must be accessed before use (typically done by a ______)
Accessing is a ____ procedure
-Once line is accessed it can be used for _____
____-term line
chest wall
SVC
specialized RN
sterile
3 days
Long
Tunneled Catheters
Typically known as _____ and _____
Tunneled underneath the skin and adhered to chest wall via a ____…the ___ grafts to the tissue to keep in place
____-term line
Broviac and Hickman
cuff
Long
ALL CVAD’s…
Should have blood return from EACH lumen
Must have placement verified (by chest x-ray, etc)
All, except Port-A-Cath, will have positive pressure caps
Dressings on most CVADs are changed every 7 days…change caps at the same time follow facility policy
Must have a biopatch (CHG impregnated sponge) or tegaderm infused with CHG over insertion site
Why does it matter?
Think of a central line as a LIFELINE.
Eliminating catheter related ______
Eliminating catheter related bloodstream infections
Central venous catheters are life-saving and the majority of patients in intensive care units (ICUs) have them placed in order to receive medicine and fluids. However, the use of these can result in serious bloodstream infections. Bloodstream infections associated with the insertion and maintenance of central venous catheters (CVC) are among the most dangerous complications that can occur. These complications worsen patients’ health, prolong hospital stay and increase the cost of care.
Key facts
___________ is the most common cause of health care-associated infection to the
bloodstream.
According to US CDC, between 12 and 25% of patients who acquire CRBSI die; many others have extended hospital stays, and increased overall treatment costs.
Each year in the United States, central venous catheters may cause an estimated 80,000 catheter-related bloodstream infections in ICUs. A total of 250 000 cases of BSIs have been estimated to occur annually if entire hospitals are assessed and, as a result, up to 62 000 deaths among patients in hospitals.
A single incident of CRBSI can cost as much as US$ 56 000 to treat according to some studies, once the cost of pharmacy charges, catheter changes, lab tests and an additional day in the ICU are added up.
(WHO, 2015)
Catheter-related bloodstream infection (CRBSI)
The leakage of blood, lymph, or other fluid, such as an anticancer drug, from a blood vessel or tube into the tissue around it.
Extravasation Injury
Right or wrong?
look at powerpoint
ICU Hemodynamic monitoring
BP can be continuously monitored through an _____- inserted in the radial artery. ____ and ____ can also be drawn from this catheter. (Note 2nd waveform: BP 135/71 and MAP 93)
______ can also be continuously monitored to assess _______. (Note 3rd waveform: CVP 8) Normal CVP is ______
Other pressures that can be measured through a swan ganz catheter:
arterial line
ABGs and labs
Central venous pressure (CVP)
fluid volume status
4-8mmHg
pulmonary artery pressure and pulmonary artery wedge pressure.
A serious infection from central lines is called –__
CLABSI
Central line-associated bloodstream infection
At what specific points in patient care, can CLABSIs occur?
Dressing changes, initiation, infusions, if hub isn’t scrubbed, ect.
How do you determine if a CLABSI is present?
Blood culture.
2 sets- one from central line, one from peripheral line
Several measures can help prevent CLABSIs including:
Hand hygiene
Sterile dressing change
CHG impregnated disc
Scrub hun for 15 sec.
CHG impregnated cap
Remove ASAP
To access an implanted port, what type of needle is used?
Huber
