PICC's Port's CVC's and other access devices Flashcards
What is the indication for a peripheral catheter?
– IV administration
– administration of antibiotics
– administration of certain cytotoxic drugs
What are the contraindications of a peripheral catheter?
– long-term treatment
– certain cytotoxic drugs
– total parenteral nutrition (TPN)
– medications with a PH of less than 5 or greater than 9
what are the complications of a peripheral catheter?
– Disconnection
– Dislodgement
– Infiltration
– phlebitis
What is a PICC?
Peripherally Inserted Central Catheter
What is a PICC used for?
– antibiotic therapy
– IV fluids
– TPN
– Blood sampling
What are the advantages of a PICC?
- preserves venous access
- one cannula only
- easy to insert
- fewer complications on insertion
Who can insert a PICC, and how is it done?
inserted by registered nurses who are trained in the procedure
sterile aseptic technique
How is a PICC removed?
- Remove dressing from bottom upward
- Don sterile gloves
- Clean site
- Place swab at exit site
- Gently withdraw catheter
- Apply pressure to exit site for 5 minutes
- Tip may be sent for sensitivity and culture if infection is suspected
- Apply dressing
What is a CVAD?
Central Venous Access Device
What are the advantages of a CVAD?
- Inserted easily and quickly
- Can be used for several therapies
- Can be used for blood sampling
What are the disadvantages of a CVAD?
- Complications associated with insertion
* Used as a temporary measure
How is a CVAD inserted, anchored and what do you need to do before use?
- By Medical practitioners
- Anchored using a skin suture
- Check chest x-ray prior to use
How do you care for a CVAD?
- Strict aseptic technique
- Lumens should be flushed before and after
- To prevent infection dressings should also be changed a minimum every seven days or sooner if no longer intact or soiled
- A transparent dressing should be used to allow visual inspection of insertion site
How should a CVAD be removed?
• Similar to PICC removal
• Suture or securement device must be
removed first
• Head down tilt to prevent complications
What are the 5 complications of a CVAD? explain each
CATHETER OCCLUSION • Clamped or kinked catheter • Tip against wall of vessel • Thrombosis • Precipitate buildup in lumen EMBOLISM • Catheter breaking • Dislodgement of thrombus • Entry of air into circulation
Long term INFECTION • Contamination during insertion or use • Migration of organisms along catheter • Immunosuppressed patient PNEUMOTHORAX • Perforation of visceral pleura CATHETER MIGRATION • Improper suturing • Trauma, forceful flushing
What are portacath?
- Treatment is administered through the skin overlying the reservoir. The reservoir is punctured with a needle and treatment is given
- Ports and access needles are available in many different types and sizes, allowing device choice to be tailored to each individual’s
What are portacaths?
Implantable ports that are used for the same reasons as any other central venous access device but are viewed as a long-term device for use in hospital and the community as they are easy to maintain and have few associated complications
What are the advantages of portacaths?
- Good for long-term therapy
- Low risk of infection
- Cosmetic discretion
What are the disadvantages of a portacath
- catheter/port malfunction
- catheter rupture and embolisation
- venous thrombosis
- Infection
How is a portacath inserted?
- Insertion and removal of implantable ports is very similar to insertion and removal of tunnelled central venous catheters
- Insertion and removal should only be carried out by experienced and competent professionals
- Implantable port insertion is a surgical technique which must be carried out within strict aseptic guidelines
How do you care for a portacath?
- Accessing implantable ports should also always be carried out using strict aseptic techniques
- Needles, once in situ, should be secured to prevent trauma and dislodgement with the use of a transparent dressing
- No needle insitu require no dressing
