Intravenous Lines: Difference between revisions
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== Peripheral IV (PIV) <ref name=":1">Doyle GR, McCutcheon. ''Clinical Procedures for Safer Patient Care.'' Victoria, BC: BC Campus; 2015 Available from: https://opentextbc.ca/clinicalskills/ [Accessed 18th April 2019].</ref> == | == Peripheral IV (PIV) <ref name=":1">Doyle GR, McCutcheon. ''Clinical Procedures for Safer Patient Care.'' Victoria, BC: BC Campus; 2015 Available from: https://opentextbc.ca/clinicalskills/ [Accessed 18th April 2019].</ref> == | ||
[[File:Peripheral IV.JPG|thumb| | [[File:Peripheral IV.JPG|thumb|325x325px|PIV]]'''Overview:''' | ||
* Common and preferred method for short-term therapy (< 6 days) | * Common and preferred method for short-term therapy (< 6 days) | ||
* A short intravenous catheter is inserted by percutaneous venipuncture into a peripheral vein | * A short intravenous catheter is inserted by percutaneous venipuncture into a peripheral vein | ||
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* Upper extremities are the preferred sites for insertion | * Upper extremities are the preferred sites for insertion | ||
* Usually attached to IV extension tubing with a positive pressure cap | * Usually attached to IV extension tubing with a positive pressure cap | ||
'''Safety Considerations:''' | '''Safety Considerations:''' | ||
* Increased risk of systemic complications in cardiac and renal patients as well as pediatric patients, neonates, and the elderly | * Increased risk of systemic complications in cardiac and renal patients as well as pediatric patients, neonates, and the elderly | ||
== Central Venous Catheter (CVC) <ref name=":1" /> == | == Central Venous Catheter (CVC) <ref name=":1" /> == | ||
[[File:Central Venous Catheter.jpg|thumb| | [[File:Central Venous Catheter.jpg|thumb|326x326px|CVC with triple lumen]] | ||
'''Overview:''' | '''Overview:''' | ||
* Also known as a central line or central venous access device | * Also known as a central line or central venous access device | ||
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* Subcutaneous or tunneled central venous catheter ("Hickman", "Broviac", "Groshong") | * Subcutaneous or tunneled central venous catheter ("Hickman", "Broviac", "Groshong") | ||
* Implanted central venous catheter (ICVC, or port-a-cath) | * Implanted central venous catheter (ICVC, or port-a-cath) | ||
[[File:PICC.png|thumb|325x325px|PICC]] | |||
'''Commonly seen in patients who:''' | '''Commonly seen in patients who:''' | ||
* require antineoplastic medications | * require antineoplastic, toxic medications, multiple, vesicant/irritant medications | ||
* are seriously/chronically ill | * are seriously/chronically ill | ||
* require central venous pressure monitoring | * require central venous pressure monitoring | ||
* require long-term venous access/dialysis | * require long-term venous access/dialysis | ||
* require total parenteral nutrition | * require total parenteral nutrition | ||
* have poor vasculature | * have poor vasculature | ||
* have had multiple PIV insertions/attempt | * have had multiple PIV insertions/attempt | ||
'''Safety Considerations:''' | '''Safety Considerations:''' | ||
* Heightened risk for developing a nosocomial infection (need strict adherence to aseptic technique) | * Heightened risk for developing a nosocomial infection (need strict adherence to aseptic technique) | ||
== Complications <ref name=":1" /> == | |||
== Administration Equipment <ref name=":1" /> == | == Administration Equipment <ref name=":1" /> == | ||
Revision as of 04:58, 18 April 2019
Original Editor - Jin Yoo Top Contributors - Jin Yoo and Kim Jackson
Introduction [1][edit | edit source]
In the acute care setting, intravenous (IV) lines have varied functions:
- to infuse fluids, nutrients, electrolytes, and medication
- to obtain venous blood samples
- to insert catheters into the central circulatory system
Common areas of placement are in the forearm or back of the hand.
There are two types of venous access: peripheral and central.
Peripheral IV (PIV) [2][edit | edit source]
Overview:
- Common and preferred method for short-term therapy (< 6 days)
- A short intravenous catheter is inserted by percutaneous venipuncture into a peripheral vein
- Held in place with a sterile transparent dressing to keep site sterile and prevent accidental dislodgement
- Upper extremities are the preferred sites for insertion
- Usually attached to IV extension tubing with a positive pressure cap
Safety Considerations:
- Increased risk of systemic complications in cardiac and renal patients as well as pediatric patients, neonates, and the elderly
Central Venous Catheter (CVC) [2][edit | edit source]
Overview:
- Also known as a central line or central venous access device
- Inserted into a large vein in the central circulation system (guided by ultrasound)
- Tip of catheter terminates in the superior vena cava leading to an area just above the right atrium
- Can remain in place for more than a year
Sub-types:
- Peripherally inserted central catheter (PICC)
- Subcutaneous or tunneled central venous catheter ("Hickman", "Broviac", "Groshong")
- Implanted central venous catheter (ICVC, or port-a-cath)
Commonly seen in patients who:
- require antineoplastic, toxic medications, multiple, vesicant/irritant medications
- are seriously/chronically ill
- require central venous pressure monitoring
- require long-term venous access/dialysis
- require total parenteral nutrition
- have poor vasculature
- have had multiple PIV insertions/attempt
Safety Considerations:
- Heightened risk for developing a nosocomial infection (need strict adherence to aseptic technique)
Complications [2][edit | edit source]
Administration Equipment [2][edit | edit source]
Assessment[2][edit | edit source]
- type of CVC and insertion date
- dressing is dry and intact
- lines and sutures are secure
- insertion site is free from redness, pain, or swelling
- positive pressure cap is attached securely
- IV fluids are running through IV pump
- number of lumens and type of fluid running through each lumen
- vital signs
- respiratory/cardiovascular examination to check for signs and symptoms of fluid overload