Central vascular Access Devices

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Presentation transcript:

Central vascular Access Devices Nicola York Clinical Nurse Manager Vascular Access Oxford Radcliffe Hospitals NHS Trust 2008

Temporary CVC

Temporary Central Venous Catheters (CVC) Inserted into internal jugular or subclavain veins (occasionally external jugular and femoral veins) Usually inserted prior to major surgery Catheters are impregnated with anti microbial –silver sulphonamide and chlorhexidine. This extends their use to 8 days. Catheters have 3-4 lumens.

Temporary Central Venous Catheters (cont) Used to administer fluids, blood products, all intravenous drugs and parenteral nutrition. Central Venous Pressure (CVP) can be monitored from the distal lumen. 15-20 cm catheter inserted. Tip of catheter lies in lower third of superior vena cava. Chest x-ray done post insertion to confirm catheter tip position and exclude pneumothorax.

PICC

Peripherally Inserted Central Catheters (PICC) Inserted into ante-cubital veins under palpation or upper arm veins using ultrasound guidance. 45-55 cm catheter inserted. Catheters have 1-2 lumens. Tip of catheter lies in lower third of superior vena cava. Tip position must be verified on chest x-ray.

Peripherally Inserted Central Catheters (cont) Used for months, often up to a year. Used to administer long term antibiotics, chemotherapy and parenteral nutrition. Can be used for blood sampling. Patients can go home with device in situ.

Tunnelled CVC

Tunnelled Central Venous Catheters Inserted into internal jugular or subclavian veins (occasionally femoral veins). End is tunnelled subcutaneously – can be cuffed or non-cuffed. Catheters have 1-3 lumens. Tip of catheter lies in lower third of superior vena cava. Chest x-ray done post insertion to confirm catheter tip position and exclude pneumothorax.

Tunnelled Central Venous Catheters (cont) Used for months, often years. Used to administer long term antibiotics, chemotherapy and parenteral nutrition. Can be used for blood sampling. Patients can go home with device in situ. Minor procedure to remove cuffed catheters.

Portacath

Portacaths Inserted into internal jugular or subclavian veins (occasionally femoral veins). Reservoir at end of catheter is buried subcutaneously. Reservoir is accessed with gripper needle. Tip of catheter lies in lower third of superior vena cava.

Portacaths (cont) Chest x-ray done post insertion to confirm catheter tip position and exclude pneumothorax. Used in patients who require life-long intravenous therapies. Improves quality of life e.g. more discreet, can swim.