Intravenous Access

Question 1

Peripheral vennous cannula
-pros and cons

Answer 1

Good
-easy to insert
-wide lumens can provide rapid infusions
-can be easily resited

Bad
-not suitable for vasopressors, chemotherapeutic agents, TPN as they damage peripheral veins

Question 2

Central line
-pros and cons
-entry points

Answer 2

Good
-multiple ports so can give multiple infusions at once

Bad
-insertion is more difficult, need US
-infusion rate generally slow

Entry points
-femoral - easiest but infection risk high
-internal jugular - preferred

Question 3

Tunneled lines

Question 5

Peripheral venous cannula
-pros and cons

Answer 5

Good
-easy to insert and resite if needed
-wide lumens can provide rapid fluid infusions

Bad
-unsuitable for vasoactive drugs (vasopressors, TPM, chemotherapy)

Question 6

Central lines
-pros and cons

Answer 6

Good
-multiple lumens for multiple infusions
-suitable for long term use

Bad
-insertion is tricky, needs US
-femoral lines easier to insert but more infection prone. Internal jugular preferred
-narrow lumen, slow infusion rate

Question 7

Tunnelled lines (Hickman lines)
-pros and cons

Answer 7

Good
-suitable for long term use
-can be linked to injection ports

Bad
-insertion needs US (tunnelled under skin into IJV)
-require formal dissection for removal
-risk of tension pneumothorax

Question 8

PICC lines
-pros and cons

Answer 8

Good
-inserted peripherally into SVC, so less prone to major complications compared to central lines
-suitable for long term use, difficult venous access

Bad
-high maintenance (flushing, dressing)