Podcast
Questions and Answers
What is the maximum recommended duration for therapies using peripheral IV catheters?
What is the maximum recommended duration for therapies using peripheral IV catheters?
- 3 days
- 14 days
- 10 days
- 6 days (correct)
Which of the following contraindications applies to the use of peripheral IV catheters?
Which of the following contraindications applies to the use of peripheral IV catheters?
- Placement in an arm without prior injuries
- Use in lower extremities
- Failure to monitor clinician administration
- Infusions with osmolarity > 900 mOsm/L (correct)
What is advised regarding the selection of a site for a peripheral IV catheter insertion?
What is advised regarding the selection of a site for a peripheral IV catheter insertion?
- Prefer veins in lower extremities
- Utilize metacarpals first
- Select veins with high phlebitis risk
- Avoid areas of flexion (correct)
Which technique is NOT typically used for inserting peripheral IV catheters?
Which technique is NOT typically used for inserting peripheral IV catheters?
In which scenario is the administration of vesicant medication allowable with peripheral IV catheter use?
In which scenario is the administration of vesicant medication allowable with peripheral IV catheter use?
What is the primary relationship between gauge size and the internal diameter of a catheter?
What is the primary relationship between gauge size and the internal diameter of a catheter?
Which statement accurately describes the tensile strength of silicone compared to polyurethane?
Which statement accurately describes the tensile strength of silicone compared to polyurethane?
What is a key consideration when using alcohol in relation to polyurethane catheters?
What is a key consideration when using alcohol in relation to polyurethane catheters?
Which of the following best explains the use of radiopaque materials in IV devices?
Which of the following best explains the use of radiopaque materials in IV devices?
What is the recommended practice regarding needle usage after the first site puncture?
What is the recommended practice regarding needle usage after the first site puncture?
Which factor is NOT typically considered during the selection of a vascular access device?
Which factor is NOT typically considered during the selection of a vascular access device?
What is a primary reason for early consultation between the vascular access specialist and the patient?
What is a primary reason for early consultation between the vascular access specialist and the patient?
In pediatric patients, which of the following is NOT a consideration for vascular access device selection?
In pediatric patients, which of the following is NOT a consideration for vascular access device selection?
Which statement about French Scale is correct?
Which statement about French Scale is correct?
Why is patient-specific vascular assessment critical in vascular access insertion?
Why is patient-specific vascular assessment critical in vascular access insertion?
Which procedure would typically require vascular access?
Which procedure would typically require vascular access?
What aspect is particularly important when assessing pediatric patients for vascular access?
What aspect is particularly important when assessing pediatric patients for vascular access?
Which of the following is NOT a complication associated with vascular access?
Which of the following is NOT a complication associated with vascular access?
Which of the following is a reason to contraindicate the use of a peripheral IV catheter?
Which of the following is a reason to contraindicate the use of a peripheral IV catheter?
Which of the following veins is considered the least appropriate for commonly administering peripheral IV catheters?
Which of the following veins is considered the least appropriate for commonly administering peripheral IV catheters?
When selecting a site for a peripheral IV catheter, which area should be specifically avoided?
When selecting a site for a peripheral IV catheter, which area should be specifically avoided?
What is an essential consideration when using ultrasound for peripheral IV catheter placement?
What is an essential consideration when using ultrasound for peripheral IV catheter placement?
Which type of medications is accepted for administration through a peripheral IV catheter with monitoring?
Which type of medications is accepted for administration through a peripheral IV catheter with monitoring?
How does the relationship between gauge size and internal diameter of a catheter affect infusion rates?
How does the relationship between gauge size and internal diameter of a catheter affect infusion rates?
Which characteristic distinguishes polyurethane catheters from silicone catheters in terms of flexibility and tensile strength?
Which characteristic distinguishes polyurethane catheters from silicone catheters in terms of flexibility and tensile strength?
What is a critical factor to consider when using ethanol lock with polyurethane catheters?
What is a critical factor to consider when using ethanol lock with polyurethane catheters?
Which size range represents central venous catheters effectively for adult use?
Which size range represents central venous catheters effectively for adult use?
What potential issue can arise from using the same needle for repeated attempts at puncture?
What potential issue can arise from using the same needle for repeated attempts at puncture?
What is a critical factor to consider during early consultation between the vascular access specialist and the patient?
What is a critical factor to consider during early consultation between the vascular access specialist and the patient?
Which factor does NOT impact the device selection for pediatric patients?
Which factor does NOT impact the device selection for pediatric patients?
Which of the following is NOT a clinical indication for vascular access?
Which of the following is NOT a clinical indication for vascular access?
What aspect of a patient's understanding is important before vascular access insertion?
What aspect of a patient's understanding is important before vascular access insertion?
What does the French Scale measure in regards to vascular access devices?
What does the French Scale measure in regards to vascular access devices?
Which of the following should be assessed in pediatric patients before vascular access insertion?
Which of the following should be assessed in pediatric patients before vascular access insertion?
Which statement regarding hydration and vascular access is accurate?
Which statement regarding hydration and vascular access is accurate?
What is a significant challenge in vascular access for pediatric patients?
What is a significant challenge in vascular access for pediatric patients?
Flashcards
VAD Selection
VAD Selection
The process of selecting the right vascular access device (VAD) for a patient, taking into consideration the patient's needs, medical condition, and projected therapies. This helps ensure optimal outcomes and minimize complications.
Vascular Assessment
Vascular Assessment
An assessment of a patient's vascular system that helps determine the best site for VAD insertion, taking into consideration factors like vessel size, location, and previous access attempts.
French Scale (Fr)
French Scale (Fr)
The size of a catheter measured in French Units (Fr). One French unit is equal to 1/3 millimeter of external diameter.
How to Calculate French Scale Measurement?
How to Calculate French Scale Measurement?
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Pediatric VAD Considerations
Pediatric VAD Considerations
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Hydration
Hydration
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Medication Administration
Medication Administration
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Total Parenteral Nutrition (TPN) or Partial Parenteral Nutrition (PPN)
Total Parenteral Nutrition (TPN) or Partial Parenteral Nutrition (PPN)
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Gauge (g or ga)
Gauge (g or ga)
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Silicone
Silicone
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Polyurethane
Polyurethane
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Relationship Between French Size and Diameter
Relationship Between French Size and Diameter
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Peripheral IV catheter limitations?
Peripheral IV catheter limitations?
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Where to avoid peripheral IV catheters?
Where to avoid peripheral IV catheters?
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Common sites for peripheral IV catheters?
Common sites for peripheral IV catheters?
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Use of metacarpal veins?
Use of metacarpal veins?
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Ultrasound guidance for peripheral IV catheters?
Ultrasound guidance for peripheral IV catheters?
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Larger French Size = ?
Larger French Size = ?
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Larger Gauge = ?
Larger Gauge = ?
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Silicone Catheter
Silicone Catheter
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Peripheral IV Catheter
Peripheral IV Catheter
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Where to insert Peripheral IV Catheters?
Where to insert Peripheral IV Catheters?
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Metacarpals and Peripheral IV Catheters
Metacarpals and Peripheral IV Catheters
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What is the French Scale?
What is the French Scale?
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What is the relationship between French size and diameter?
What is the relationship between French size and diameter?
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What are important considerations for Pediatric VAD selection?
What are important considerations for Pediatric VAD selection?
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Why is early collaboration vital in VAD selection?
Why is early collaboration vital in VAD selection?
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What factors should be considered during VAD selection?
What factors should be considered during VAD selection?
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What is VAD selection?
What is VAD selection?
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What is a vascular assessment?
What is a vascular assessment?
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What is Total Parenteral Nutrition (TPN) or Partial Parenteral Nutrition (PPN)?
What is Total Parenteral Nutrition (TPN) or Partial Parenteral Nutrition (PPN)?
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Study Notes
Device Selection - General
- Early consultation between the vascular access specialist and the patient/family is crucial for optimal outcomes.
- Patient variables (at admission) and projected therapies are reviewed to promote timely and appropriate vascular access insertion.
- Vascular access insertion aims to minimize complications and ensure safe infusion delivery.
- Patient preferences, daily activities, lifestyle, and employment are considered.
- Patient understanding of the diagnosis and therapy is assessed.
Pediatric Considerations
- Device selection may be limited in children due to smaller vessel size.
- Multiple attempts, previous complications, and developmental stage are factors.
- Clinicians for pediatric vascular access must have specific training.
- Minimizing venipuncture attempts is vital for pain and anxiety reduction.
- Factors including age, size, vascular sites, reason for therapy and duration, activity, and mobility, cognitive ability, fine and gross motor skills, and body image must be considered.
Indications for Vascular Access
- Hydration
- Medication administration
- Parenteral nutrition (TPN or PPN)
- Chemotherapy
- Blood products
- Clinical/diagnostic needs
- Hemodynamic monitoring
- Plasmapheresis/Aquapheresis/Hemodialysis
- Frequent blood sampling (difficult access patients)
- Therapeutic phlebotomy
Device Facts
- French scale (Fr): measures external catheter diameter. Larger Fr number, larger diameter. Central venous catheter sizes range from 1.2 Fr (neonatal PICCs) to 15 Fr (dialysis catheters).
- Gauge (g or ga): measures internal catheter diameter. Smaller gauge number, larger internal diameter. Higher infusion rates are associated with larger gauge catheters.
- Needle characteristics: Single use, intended for tissue piercing once. Repeated attempts can damage tissue, cause contamination, and dull the needle.
- Catheter Materials: All IV devices in the USA are radiopaque.
Silicone
- Soft, biocompatible polymer
- Extremely flexible
- Lower tensile strength (compared to polyurethane) resulting in a higher inner/outer diameter ratio
- Not affected by chemicals such as alcohol
Polyurethane
- Biocompatible urethane-based polymer material
- Various formulations used in peripheral and central venous catheters
- Alcohol can act as a solvent on some types of polyurethane catheters, possibly causing degradation; consider manufacturer instructions before use with ethanol locks.
Peripheral Catheters
- Short and long peripheral IV catheters exist in current clinical practice.
- Length ranges from 0.56" to 2.5" and 14mm to 10cm
- Common insertion methods: catheter-over-needle, accelerated, modified Seldinger.
Indications/Contraindications
- Indications: Infusions projected for 6 days or less; Non-irritant and non-vesicant medications/solutions; Single dose (non-continuous) vesicant administration (clinician monitored).
- Contraindications: Therapies for more than 6 days; Osmolarity >900 mOsm/L; Infusates with high phlebitis risks; Placement in arms with thrombosis, fractures, trauma, impaired circulation, mastectomy, or A/V fistula (graft).
Insertion Procedures and Supplies
- Follow manufacturer's instructions.
- Aseptic non-touch technique
- Skin antisepsis
- Limited attempts per healthcare provider (two attempts per individual, up to 4 before referring to a vascular access specialist)
- Successful access unlikely based on clinician assessment, refer to a more experienced clinician or specialist.
- Select smallest possible gauge (for delivery of prescribed therapy).
- Consider visualization technology.
- Peripheral IV catheter
- Skin antiseptic agent
- Gloves
- Extension set
- Needleless connector
- Normal saline (NS) flush solution
- Transparent dressing (TSM) or antimicrobial dressing
- Skin adhesive
- Tissue adhesive
- Skin protectant
- Engineered stabilization device
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Description
This quiz focuses on the essential considerations for selecting vascular access devices, particularly in pediatric patients. It addresses the importance of early consultations, patient variables, and the minimization of complications during insertion. Understanding both adult and pediatric patient needs is crucial for optimizing vascular access outcomes.
