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Flashcards in Central Venous Catheters Deck (82)
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Why would someone need a CVC?

When pts are in need for long-term infusion therapy, or because their condition or disease processes require special types of meds or treatments; commonly inserted peripheral IV therapy may not be practical.


Where does the tip of a central venous catheter lie?

Tip lies in the Cavo-Atrial Junction


What are the four devices that can be used for central venous therapy?

Centrally inserted catheters
Peripherally inserted catheters
Centrally inserted ports
Peripherally inserted devices


What are the major indications for central venous therapy?

Inadequate peripheral access
Complex treatment regimes
Hyperosmolar infusions
Infusion of irritating or vesicant drugs


What are some other indications for central venous therapy? (Besides the major indications)

Rapid absorption and rapid blood and tissue perfusion
Long-term IV therapy
Patient preference


What are some considerations when deciding on insertion of a central venous catheter?

These are mainly related to patient condition, underlying disease processes, and/or anatomical structural deviations or pathologies
Other considerations
IV drug users
Potential need for dialysis (permacath)


What are the usual sites for insertion of a central venous catheter?

Subclavian vein
Internal or external jugulars


What is a less frequently used site for central venous catheter?

Femoral access (This is less common because it's easier to get an infection. It's usually reserved for emergency situations, and the goal is to re-site within 48 hours).


What are some peripheral access sites for central venous catheters?

Basilic, cephalic & median cubital


What are some characteristics of centrally inserted catheters?

Flexible, single or multiple lumen catheters
Open or closed ended
Valved or non valved
Short term or long-term


What are two types of short term central venous catheters?

Percutaneous (non-tunneled, non-cuffed)


What are three types of long-term central venous catheters? (and brand examples)

Tunneled (i.e. Hickman, Broviac, Groshong)
Implanted Vascular Access Device (IVAD)
Peripherally Inserted Central Catheters (PICC) (i.e. Groshong, power PICC, Solo)


What are the numbers of lumens available for central venous catheters?

Single, double, triple, or quadruple


Can incompatible meds be infused simultaneously through separate lumens of the same central venous catheter?

Yes. Incompatible meds can be infused simultaneously via separate lumens. Each lumen must be treated as a separate catheter.


What is the suggested use for the proximal lumen (in a triple lumen CVC)?

Medication administration


What are the suggested uses for the medial lumen (in a triple lumen CVC)?

TPN, medication or fluid administration


What are the suggested uses for the distal lumen (in a triple lumen CVC)?

Blood administration, high volume fluids, medication, CVP monitoring, Blood sampling


What are the characteristics of an open-ended CVC?

Catheter is open at the distal end
Requires clamping before entry into the system
Clamps are usually present
Any type of CVC can be open ended


What are the characteristics of a closed-ended CVC?

Valve is present at tip or hub of catheter
Valve stays closed except when aspirating or infusing
Clamping is not required


What do we use to flush open ended CVCs?

Requires SALINE (some still require low dose heparin)


What kind of CVC's can be open ended?

Any type of CVC can be open ended


What type of CVCs can be closed-ended?

May be present on tunneled CVC's, IVAD's, PICC's


Is clamping required for a closed ended: distal valve CVC?

Clamping is not required


Is clamping required for an open-ended: proximal valve CVC?

Clamping is not required


What are the advantages of short term catheters?

All types of therapies can be administered
Multiple lumens, larger diameter of lumens
Preserves peripheral veins


What are the disadvantages of short term catheters?

Highest risk of infection and post insertion complications
Not for home therapy use or long term use
Can be easily dislodged


What is a tunneled long term catheter?

Inserted by percutaneous venipuncture or surgical cutdown
Can be open ended or valved (closed)
A portion is tunneled through the subcutaneous tissue from the exit sited to the insertion site
Has a Dacron cuff positioned in the subcutaneous tissue (2-5cms from exit site) to minimize the risk of infection and to promote securement of the catheter


What are some characteristics of long term catheters?

Generally a tunneled or implanted device/port
Made of soft, medical grade silicone
Dracon cuff near the exit site
Surgically inserted via percutaneous cutdown
Can be single or multilumen
Can last months to years


What are some advantages of tunneled long term catheters?

Designed for long term therapy
All types of therapies can be administered
External segments can be repaired
Can be single or multi lumen
Low infection risk
No dressing required once insertion site healed


What are some disadvantages of tunneled long term catheters?

Surgical procedure to insert and remove (IR or OR)
Can impact body image (external device)
Removed by physician/surgical procedure