VENOUS ACCESS CATHETERS SUMMARY REFERENCE GUIDE Short Term – Hi

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VENOUS ACCESS CATHETERS SUMMARY REFERENCE GUIDE Short Term – Hi Powered By Docstoc
					                                                         VENOUS ACCESS CATHETERS SUMMARY REFERENCE GUIDE
                                                              Short Term –                  Hickman       Groshong                                            Implanted Ports       Dialysis Catheter/
 Catheter Type         Peripheral               Midline      Triple Lumen,     PICC        (Tunneled     (Tunneled                                                                       Pheresis
                                                               subclavin,                  Catheter)    Catheter/valve                                           MCP 393.1          (Vas Cath/ Perm
                       MCP 394.1               MCP 393.1         Cordis      MCP 393.1     MCP 393.1      Groshong                                                                        Cath)
                                                               MCP 393.1                                 MCP 393.1                                                                     MCP 393.1
 Tip Location       Upper Extremity;
                   Order required for         Axillary Fold                 SVC                   SVC                   SVC                   SVC                   SVC                     SVC
                    lower extremity                                                                                                                                                      or IVC if
                       insertion                                                                                                                                                      femoral insertion
   Catheter            96 Hours                  4 Weeks              7 Days – 14 Days           1 year              2-3 years              2-3 years         1000-2000 access       VasCath 2-3 wks
   Duration                                                                                                                                                       punctures         Permcath indefinite
   Flushing          Minimum 3 ml of       10 ml of 0.9%                                   10 ml of 0.9%         10 ml of 0.9%         10 ml of 0.9%         10 ml of 0.9%         Only performed by
   Protocol        0.9% Sterile Normal     Sterile Normal                                  Sterile Normal        Sterile Normal        Sterile Normal        Sterile Normal        Dialysis nurses or
                    Saline for Injection   Saline; Followed by             Same as         Saline; Followed      Saline Followed       Saline after each     Saline followed by    Designated RN’s
                                           3 ml 100 Units/ml               Midline         by 3 ml 100           by 3 ml 100           access or at least    5 ml 100 Units/ml     High Dose Heparin
                                           Heparin after each                              Units/ml Heparin      Units/ml Heparin      Q1 week               Heparin after each    per priming volume
                                           access; at least Q 12                           after each access;    after each access;                          access or at least    of catheter
                                           hours                                           at least Q 12 hours   at least Q 12 hours                         Q 1 month
    Dressing          Every 4 days                                                                                                                                                  Dressing changed
    Change              and PRN                                                                       Every 7 days and PRN                                                           after dialysis or
                     Date and Initial                                Using Sterile Technique (Gloves and Mask) and Central Line Dressing Change Kit                                Pheresis treatment by
                        Dressing                                                                 Date and Initial ALL Dressings                                                      Dialysis nurses
 Injection Cap      Luer Lock Access                                         Positive Pressure Access Valve to be maintained AT ALL TIMES on each catheter lumen hub
                      Valve Device                                                  Positive Pressure Access Valve to be changed with each dressing change and PRN
Blood Sampling             Not                  Not                Discontinue or stop infusions It is recommended that the distal lumen be used for blood sampling               Only by Dialysis
                      recommended           recommended            Verify patency by flushing lumen with 10 ml of 0.9% Sterile Normal Saline for Injection                        Nurses or Designated
                                                                   Aspirate 3-5 ml of blood and discard Withdraw specimen using syringe or vacutainer technique                         RN’s
                                                                   Flush lumen with 10 ml of 0.9% Sterile Normal Saline for Injection if continuous infusion
                                                                   Re-initiate infusion as indicated. For intermittent use, flush catheter with Heparin per catheter
                                                                      protocol
    Special        Requires physician     Do not use             No hemostats or           Do not use          Pre-attached         NO added              Use non-coring    Catheter to be
 Consideration     order for dwell time    tourniquet, BP          clamps with sharp         tourniquet, BP        clamps to remain      clamps to be used      “Huber” needle     clamped at all times.
                   >96 hours               cuffs on arm or         edges.                    cuffs on arm or       locked with lumen with catheter              for accessing      Routine site care
                                           clamp catheter           Pre-attached            clamp catheter        not in use                                   When accessing,   and maintenance to
                                           Appropriate for        clamps to remain          Pre-attached         No hemostats or                             “tap bottom” of    be performed by
                                           isotonic or near        locked when lumen         clamps to remain      clamps with sharp                            reservoir          dialysis nurses
                                           isotonic solutions      not in use                locked when           edges.
                                                                                             lumen not in use
   Catheter        After removal apply     RN’s with MD            RN’s with MD order         MD or Qualified           MD Only               MD Only                MD Only             MD Only
   Removal         pressure and gauze      Order                                                     RN
                   dressing

For additional information on general intravenous therapy refer to MCP 391.1.
For additional information on declotting of venous access refer to MCP 390.1)