Week 9 - CVAD Flashcards
What are the different types of CVADS?
- PICC
- non-tunnelled CVADS
- tunnelled CVAD
- IVAD
- hemodialysis catheter
How long can a PICC be used for treatment?
more than 1 month but less than 1 year
Where are PICC lines inserted in the periphery?
- cephalic
- basilic
- medin cubital vein
where does the tip of a PICC rest?
- lower portion of the distal superior vena cava
how many lumens can a PICC be?
- single lumen
- double lumen
- triple lumen
Where are the 3 places a non-tunnelled CVADS can be placed?
- jugular
- subclavian
- femoral (not common)
when are non-tunnelled CVADS used?
short term/ emergent therapy
how long can a non-tunnelled CVADS be left in place? why?
7 days to a month b/c of increased risk of infection
where is a non-tunnelled CVADS placed?
- internal jugular
- external jugular
- subclavian vein
- rarely in femoral vein
Who inserts a non-tunnelled CVADS? What needs to be done after?
- surgically sutured by a physician
- placement needs to be verified by CXR
what lumens can a non-tunnelled CVADS be?
- single lumen
- double lumen
- triple lumen
What do non-tunnelled CVADS require?
- sterile dressing
- heparin flush solution to maintain patency
where is a percutaneous CVAD inserted?
internal jugular or subclavian vein
When are tunnelled CVADS used?
- long term intermittent
- continuous access
- treatments expected to last more than 1 year and long term
where is a tunnelled CVADS inserted?
- subclavian or internal jugular vein
in regards to a tunnelled CVADS where is the proximal end placed?
- tunnelled subcutaneously from the insertion site (10-15cm)
- brought out through skin at an exit site
What does the tunnelled portion of a tunnelled CVADS have?
Dacron cuff
where is a dragon cuff placed in regards to a tunnelled CVADS?
under the skin just above the exit site
what will happen to the dacron cuff in 3-4 weeks in regards to a tunnelled CVADS?
- granulation tissue will grow onto cuff
- creates a seal
- seal helps keep catheter from slipping out/ acts like a barrier to infection
how is a tunnelled CVADS inserted?
surgically in OR or in medical imaging under fluoroscopy
what lumen size can a tunnelled CVADS be?
- single lumen
- double lumen
- triple lumen
what does a tunnelled CVADS require?
heparin flush solution to maintain patency
is a dressing required for a tunnelled CVADS?
- required until site is healed
- no dressing needed at home
when is an IVAD used?
- long term IV therapy
- treatments expected to last more than 1 year