Podcast
Questions and Answers
What is the relationship between catheter size in French (Fr) and internal diameter in gauge (g)?
What is the relationship between catheter size in French (Fr) and internal diameter in gauge (g)?
What are the potential risks associated with repeated use of the same needle?
What are the potential risks associated with repeated use of the same needle?
Which statement is correct regarding the tensile strength of silicone and polyurethane catheters?
Which statement is correct regarding the tensile strength of silicone and polyurethane catheters?
Why are all IV devices manufactured in the USA required to be radiopaque?
Why are all IV devices manufactured in the USA required to be radiopaque?
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What can alcohol potentially do to certain types of polyurethane catheters?
What can alcohol potentially do to certain types of polyurethane catheters?
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What is crucial for achieving optimal outcomes in vascular access device placement?
What is crucial for achieving optimal outcomes in vascular access device placement?
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Which factor is NOT recommended to be assessed during patient evaluation for vascular access device selection?
Which factor is NOT recommended to be assessed during patient evaluation for vascular access device selection?
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In the pediatric population, which of the following is particularly important to minimize during vascular access procedures?
In the pediatric population, which of the following is particularly important to minimize during vascular access procedures?
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Which of the following conditions is a valid indication for vascular access?
Which of the following conditions is a valid indication for vascular access?
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How is the French size (Fr) of a catheter measured?
How is the French size (Fr) of a catheter measured?
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What should be taken into account regarding the patient's vascular assessment?
What should be taken into account regarding the patient's vascular assessment?
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Which of the following therapies would not require vascular access?
Which of the following therapies would not require vascular access?
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What factor might limit device selection in the pediatric population?
What factor might limit device selection in the pediatric population?
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What is a contraindication for using a peripheral catheter?
What is a contraindication for using a peripheral catheter?
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Which of the following veins is recommended for peripheral catheter insertion?
Which of the following veins is recommended for peripheral catheter insertion?
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In which scenario should a peripheral catheter be considered for use?
In which scenario should a peripheral catheter be considered for use?
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Which of the following techniques can be used for peripheral catheter insertion?
Which of the following techniques can be used for peripheral catheter insertion?
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What depth consideration should be taken when using ultrasound for catheter placement?
What depth consideration should be taken when using ultrasound for catheter placement?
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Which statement correctly describes the relationship between catheter size and internal diameter?
Which statement correctly describes the relationship between catheter size and internal diameter?
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What is a key characteristic of needles used in medical procedures?
What is a key characteristic of needles used in medical procedures?
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Which of the following materials is characterized by high tensile strength and is less affected by chemical solvents?
Which of the following materials is characterized by high tensile strength and is less affected by chemical solvents?
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Why must ethanol lock application be carefully considered when using polyurethane catheters?
Why must ethanol lock application be carefully considered when using polyurethane catheters?
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Which characteristic of catheter materials is specifically required for IV devices manufactured in the USA?
Which characteristic of catheter materials is specifically required for IV devices manufactured in the USA?
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What is a primary indication for the use of peripheral IV catheters?
What is a primary indication for the use of peripheral IV catheters?
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Which of the following is a contraindication for using a peripheral catheter?
Which of the following is a contraindication for using a peripheral catheter?
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Which veins are preferred for peripheral catheter insertion?
Which veins are preferred for peripheral catheter insertion?
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Which factor should be avoided when selecting a site for peripheral IV catheter placement?
Which factor should be avoided when selecting a site for peripheral IV catheter placement?
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What is a primary recommendation when using ultrasound for catheter placement?
What is a primary recommendation when using ultrasound for catheter placement?
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What factor is essential for enhancing the safety and effectiveness of vascular access device (VAD) placement?
What factor is essential for enhancing the safety and effectiveness of vascular access device (VAD) placement?
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Assessing which of the following is NOT typically included when evaluating a pediatric patient for vascular access?
Assessing which of the following is NOT typically included when evaluating a pediatric patient for vascular access?
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Which of the following statements about device selection for pediatric patients is correct?
Which of the following statements about device selection for pediatric patients is correct?
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Which of the following is a recognized indication for requiring vascular access?
Which of the following is a recognized indication for requiring vascular access?
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How is the French size (Fr) of a catheter determined?
How is the French size (Fr) of a catheter determined?
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Which of the following factors is critical to consider in a patient's assessment for vascular access device selection?
Which of the following factors is critical to consider in a patient's assessment for vascular access device selection?
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What is one of the pediatric considerations that may impact vascular access device selection?
What is one of the pediatric considerations that may impact vascular access device selection?
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When selecting a vascular access device, which of the following is a common complication that may arise?
When selecting a vascular access device, which of the following is a common complication that may arise?
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Study Notes
Device Selection - General
- Early consultation between the vascular access specialist and patient/family is crucial for optimal outcomes.
- Reviewing patient variables (at admission) and projected therapies helps with timely and appropriate device insertion.
- This reduces complications and ensures safe delivery of treatments.
- Consider patient preferences, daily activities, and lifestyle when selecting the device.
- Understanding of diagnosis and therapy is crucial for patient and caregiver.
- Early consultation ensures the correct device is placed in the right location at the right time preserving vessel health.
Pediatric Considerations
- Device selection may be limited due to smaller vessel size in children, impacting visualization and palpation.
- Multiple attempts, previous complications, and developmental stage are considerations.
- Clinicians need specific training for pediatric vascular access.
- Minimizing venipuncture attempts reduces pain and anxiety, preserving vessels.
- Assessment of age, size, vascular access sites, reason for therapy, duration of therapy, activity and mobility, cognitive ability, gross and fine motor skills, and body image is necessary
Indications for Vascular Access
- Hydration
- Medication administration
- Total/partial parenteral nutrition (TPN/PPN)
- Chemotherapeutic agents
- Blood/blood components
- Clinical/diagnostic needs (monitoring, etc).
- Plasmapheresis/Aquapheresis/Hemodialysis
- Frequent blood sampling in difficult access patients
- Therapeutic phlebotomy
Device Facts
- French Scale (Fr): Measures external diameter of a catheter. Larger Fr numbers indicate larger diameters.
- Gauge Scale (g/ga): Measures inner diameter. Smaller gauge numbers indicate smaller diameters.
- Catheter sizes range from neonatal (1.2 Fr) to dialysis (15 Fr).
- Needle characteristics include single use, various lengths, and bevels. Repeated use can cause damage, site contamination, and dullness.
Peripheral Catheters
- Short and long peripheral IV catheters are used.
- Catheter lengths vary from 0.56" to 2.5" (14mm to 10cm).
- Insertion methods include catheter-over-needle, accelerated, or modified Seldinger.
- Suitable for infusions expected to last 6 days or less.
- Non-irritant and non-vesicant medications are preferred.
- Avoiding areas of flexion (hand, wrist, antecubital fossa) is important during insertion, especially with ultrasound guidance.
Contraindications for Peripheral Catheters
- Therapies expected to last longer than 6 days.
- Infusions with osmolarity greater than 900 mOsm/L.
- Vesicants/irritant medications.
- Placement in compromised areas (e.g. thrombosis, fracture, infection).
- Veins in the same arm as mastectomy, A/V fistula or graft.
- Avoid vessels in the lower extremities in adults.
Insertion Procedures
- Follow manufacturer's instructions and the aseptic non-touch technique.
- Perform skin antisepsis.
- Limit attempts per healthcare provider (e.g. 2 attempts per provider to a maximum of 4 attempts).
- Ensuring at least 50% of the catheter length is within the vein during insertion length considerations are important
- Consider using visualization technology, particularly for difficult cases or when the vessels are difficult to visualize.
- Use proper anatomical landmarks and guidelines during insertion.
Supplies
- Catheter
- Skin antiseptic
- Gloves (consider sterile)
- Extension sets
- Needleless connectors
- Normal saline flush
- Dressing (semi-permeable/antimicrobial)
- Skin adhesive/protectant
- Tissue adhesive
- Stabilization devices
- Alcohol lock should be considered when using polyurethane catheters
- Avoid using alcohol on all devices as it can act as a solvent and may cause degradation
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Description
Test your knowledge on vascular access devices, including catheter sizes, potential risks, and best practices in placement. This quiz covers important topics related to pediatric considerations and materials used in catheter manufacturing. Discover the nuances of ensuring safe and effective vascular access.