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CATHETER
WHAT IS A CENTRAL VENOUS
CATHETER
A central venous catheter, or vascular
access device(VAD), is a long, thin,
flexible tube used to give medications,
fluids, nutrients, or blood products over
a long period of time, usually several
weeks or more. The catheter is inserted
through the skin into a vein often in the
neck or chest. It is threaded through
the vein until it reaches a large vein
near the heart called the superior vena
cava
USE OF CENTRAL VENOUS
CATHETER
To give long term medication treatment
for pain, infection, cancer, or to supply
nutrition. A central venous catheter an
be left in place far longer than an
intravenous catheter IV, which gives
medications into a vein near the skin
surface
Give medications that affect the heart,
especially if a quick response is wanted
Measure the blood pressure in the
superior vena cava, which can help
diagnose certain heart problems
CARE OF CENTRAL
VENOUS CATHETER
The type of CVC to be placed will depend upon the
type of cancer that you will treat and the therapy you
will most likely need. The catheter can remain for
weeks to months.
SIGNS OF CATHETER PROBLEMS:
If there are signs of infection or catheter problem, call
doctor immediately.
*Redness, tenderness, drainage, warmth or odor
around the site
*Fever of 100.5F(38C)or greater, or chills present.
*Swelling of the face, neck, chest, or arm on the
side where catheter is inserted
*Leakage of blood or fluid at the catheter site or
the cap
*Inability to flush the catheter or resistance to
flushing the catheter
*Displacement or lengthening of the catheter.
GUIDELINES FOR CENTRAL
VENOUS CATHETER CARE
Do not let CVC exit site get wet until it
is well healed. You may shower 72hrs
after the catheter has been inserted.
When you bathe or shower, you must
cover the site with waterproof
material such as plastic wrap taped
over the dressing
Do not submerge the CVC site or caps
below the level of water in a bath tub
or swimming pool.
Store CVC supplies in a clean, dry
place such as a shelf in a closet or a
drawer.
Always clean your work area with
alcohol and let it dry completely.
Use only sterile supplies. Open all
packages carefully without touching
the contents. Handle dressing at the
edges
Never use scissors, pins or sharp
objects near CVC or other tubings
Remember to wash hands thoroughly
before and after working with the CVC.
COMPLICATIONS
Bleeding caused by inserting the
catheter into the vein.
Collapsed lung(pneumothorax).The risk
of a collapsed lung varies with the skill
of the person inserting the catheter
and the site of placement. It is most
likely during placement of a catheter in
the chest, although the risk is small
Infection requiring treatment with
antibiotics or removal of the catheter.
Blockage or kinking of the catheter.
Regular flushing of the catheter helps
reduce blockage. A kinked catheter
must be repositioned or replaced
Pain. You may experience at the
point where the catheter enters your
vein.
Shifting of the catheter. A catheter
that has moved out of place can
sometimes be repositioned. If
repositioning does not work, it must
be replaced
Changing the CVC
Dressing
The CVC dressing is changed every 5
days if you are using a transparent
dressing. Change it every 48 hrs. if
you are using gauze or dressing.
A senior/charge nurse will give
specific instructions to you and your
caregiver about the type of dressing
Flushing the Catheter with
Clamp
*Tuberculin Syringe
*Arterial Hand support or #3
tongue depressors
*Pressure bag
*Bandage Scissors
*Micropore Tape
*Disposal bag (yellow)
Do hand washing both for the nurse
and the doctors, then wear gloves
ROLE OF NURSES
The nurse will then position the hand of
the patient by hyperextending it to
provide maximum exposure
After the site is chosen, use the the
cotton balls with alcohol to wipe the
site in circular motion from the inner to
outer. Repeat by using different cotton
balls with 70%alcohol if the site is
dirty or as necessary.
Encourage patient to take deep breath
as the doctor inject lidocaine 2% until
it forms a wheel.
Verify the pain status as the doctor
inserts the IV cannula.
When there is an appearance of blood
in the cannula, the nurse will place 4x4
OS below the opening of the cannula.
The doctor will then withdraw the
stylet while advancing the plastic
cannula to the artery.
The nurse will connect the tip of the
arterial set to the cannula to aspirate
for blood and ensure patency.Flush the
remainder of the blood back to the
artery since the arterial set is
pressurized by pressure bag.
In case the insertion was unsuccessful,
nurse will pit digital pressure with the
aid of 4x4 OS to the site for 5mins. This
will prevent bulging and hematoma to
the site that was inserted. The doctor
will select another insertion site.
The nurse will clean the site and place
transparent dressing.
The nurse will place 3 tongue
depressors on the prone surface of the
hand for support then place the roll
gauze over the entire hand to ensure
that the hand will not bend.
The doctor and the nurse will confirm
the tracing on the Cardiac Monitor and
compare the reading to NIBP monitor
The nurse or the doctor will verify the
patient condition and feelings
regarding the arterial line that was
inserted.
Dispose all sharps collector and other
disposable materials in the yellow bag
Document the procedure