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Central Venous Access Devices Made Incredibly Easy!
- 1. Central Venous Access Devices Made Incredibly Easy Adapted from a 2005 project
- 6. 1. Implanted Port vs. External Photo: C. Lewis Photo: Unknown
- 7. Implanted CVCs (Port-A-Cath) Insertion performed in O.R. or Radiology Suite
- 8. 2. External: Tunneled vs. Non Tunneled Photo: Unknown
- 9. Peripherally Inserted Central Catheter (PICC) Photo: C. Lewis
- 12. 4. How Many Lumens?
- 13. 5. Is the Catheter Designed for Dialysis or Apheresis? Photo: C. Lewis Photo: C. Lewis Patients receive ID card at time of insertion.
- 37. Pinch-off Syndrome Source: Unknown
- 39. Line Care
- 51. Percutaneously Inserted Central Catheter (PICC) 1
- 53. Implanted Vascular Access Device (Port-A-Cath) 2
- 57. Tunneled Dialysis Catheter 4
Notes de l'éditeur
- Advanced
- Super users group
- If you can answer all of these questions, you can figure out how to assess and care for this catheter.
- From http://www.aegis.com/pubs/step/1992/STEP4301.html Central Catheters, Implanted Ports Implanted ports have all of the advantages of a central line except they are not always immediately available for use. A port is a small titanium reservoir with a rubber "stopper" that is attached to the catheter entering your vein below the collarbone. The whole thing is implanted under the skin in an outpatient procedure with local anesthesia and IV sedation. These catheters are usually not noticeable under your skin, but may sometimes show as a small lump. In order to use this catheter, the nurse must locate and clean the site, and place a special needle through the skin and into the rubber stopper. This can be done for each dose of medication or left in place with a plastic dressing and weekly changes. Ports that remain in place between usages are usually bulkier and more cumbersome to "wear" than a tunnelled catheter, and the dressing needs to be kept clean and dry. The ports are made to withstand 2000 needle entries, but this does irritate the skin over the port. Most people develop a callus that quits hurting when the needle is placed through the skin. As a patient, you can be taught to clean the site and access the port with a needle, but it is difficult to learn and complicated to do. Because of the procedures involved in accessing the port for use, these catheters are usually not recommended for daily or more frequent medications. They are perfect for someone who gets a medication only once a week or for a week every six weeks or some other intermittent schedule. One type of implanted port is actually placed in the arm near the elbow and the catheter line threaded up the vein to the Superior Vena Cava, but they offer no particular advantage over a chest port, tend to have more complications, and are harder for the patient to self-access since two hands are almost required for the procedure. When the port is not accessed, it is hardly visible and requires no care other than a once monthly access for flushing with heparin. Patients with unaccessed ports can swim, though sometimes a doctor will recommend covering the site with a waterproof plastic dressing. Since the skin is an excellent barrier to bacteria, unaccessed ports rarely become infected. However, frequent accessing of a port, or leaving the access in place for extended periods can make the odds of infection greater than with with a tunnelled-type catheter. Blood can be drawn from a port for lab tests, if your doctor consents.
- Super users
- From: Nursing 92, June, p. 27 From Nursing 92, June, p. 27
- Illustration adapted from Bagnall-Reeb, H. (1998). Journal of Infusion Nursing 21(5S):S115-S121.
- Illustration adapted from Bagnall-Reeb, H. (1998). Journal of Infusion Nursing 21(5S):S115-S121.
- Super users
- If you can answer all of these questions, you can figure out how to assess and care for this catheter.