Module 5: Vascular Access Devices and Sites Flashcards
What is an Arterial Line (a-line, art line)
Catheter placed on artery. Commonly in the radial artery.
Purpose of A-line
collect blood gas and other blood specimen, and administer drugs such as dopamine
Reminders for A line
Only specialized personnel can access.
Never place tourniquet
What is an Arteriovenous Shunt, Fistula, or Graft?
permanent surgical connection of an artery and vein by direct fusion (fistula)— results in bulging vein. Or with piece of vein or tubing (graft) that created loop under skin.
Purpose of AV fistula, shunt, graft
For dialysis— joins radial artery and cephalic vein above wrist on underside of the arm.
Buzzing sensation in AV fistula, shunt, graft
Thrill
What i a blood sampling device?
Needless closed blood sampling device. Connected to arterial or central venous catheter for blood collection.
Advantages of Blood Sampling Device
- less risk of infection
- no neddlestick injury
- less waste
Example of blood sampling device
VAMP (venous arterial blood management protection system)
What is a heparin or saline lock?
catheter or cannula connected to a stopcock or cap with diaphragm used for administering medication or blood collection. Placed on a vein in the lower wrist and can be left up to 48 hours. Often flushed with heparin or saline to prevent clotting of blood.
How many ml should be removed in heparin or saline locks before collecting for tests?
5ml in discard tube
What test is not recommended for blood collected from heparin or saline locks?
Coagulation tests
What does intravenous mean and what is it?
“of, pertaining to, or within a vein”. Catheter inserted in a vein to administer fluids (also known as IV).
Can blood specimens be drawn from IV sites?
No. they can be contaminated with fluids or diluted with IV fluids.
Alternative choice if both arms have IV line?
- capillary puncture
- If large amounts are needed, find other sites such as foot or ankle
- below IV line
Steps to follow when collecting blood from IV line
- ask nurse to turn off IV for at least 2 minutes prior collection
- Apply tourniquet distal to line
- select site distal to IV
- Perform venipuncture in dif. vein than the one with IV
- Ask nurse to restart
- Document that specimen was collected under IV
How many hours should pass before collecting specimens from previous IV sites?
24-48 hours (1-2 days)
What are Central Vascular Access Devices?
Also known as INDWELLING LINE. These are tubings inserted on main vein or artery. Used for administering medication, monitoring pressure, drawing blood.
Benefits of CVADs?
- practical for patients who need extended time for IV line
- beneficial for patients who do nor have easily accessible veins.
Only specially trained personnel can have access to CVADs to draw blood, but phlebotomist can assist in placing specimen in proper tubes.
True or False?
TRUE
Use of saline or heparin in CVADs?
Flush solutions to avoid thrombosis
How much blood should be discarded to avoid contamination of flush solution?
Non-coagulation: 2x dead space
Coagulation: 6x dead space (about 5mL)——- typically not recommended
Three types of CVADs?
- CVC- central venous catheter or central venous line
- Implanted port
- PICC- Peripherally Inserted central catheter
Describe CVC?
Line inserted in large vein such as subclavian ad into the superior vena cava, proximal to right atrium.
Exit is surgically tunneled under skin to site several inches away the chest.
Has one or more short tubings that protrude from exit site, covered with transparent dressing.
Describe Implanted port
Small chamber attached to an indwelling line that is surgically implanted under skin and most commonly located in upper chest or arm. Can be located by palpating skin and accessed by inserting special needle through skin into self-sealing septum of chamber. Not covered with bandage.
Describe PICC or Peripherally inserted central catheter
line inserted in peripheral venous system (veins of the extremities) and threaded into central venous system (main veins). No need for surgery. Placed in an antecubital vein, below or above antecbital fossa.
