Vascular Access Part 1:
Reducing risk and increasing catheter
longevity
The aim
of having a structured decision matrix in the approach to vascular
access is to reduce catheter-associated complications and to
increase device longevity. There are over 15,000 central venous
catheters placed in Australia annually. The actual insertion
process for placing a central line only accounts for a small part
of the 'life span' of that line (approximately 1%), but the choices
made at the time of insertion have a huge impact on the
longevity of the device and the associated complications. In this
introductory talk Evan Alexandrou outlines the top ten tips for
reducing complications associated with vascular access
devices:
Always use ultrasound: Never do
a blind puncture
Ensure with the site chosen for
the catheter that it exits the skin on a flat surface.
Consider the Axillary vein in
preference for the subclavian vein
Use micro-puncture
techniques
Avoid using a scalpel if
possible
Avoid catheters being inserted
all the way to the hub
Use impregnated dressings when
possible
Use sutureless securing
techniques
Secure the dressing on a flat
surface (refer rule 2)
Ensure optimal positioning of
the catheter tip by utilising ultrasound or intracavitary
ECG
We hope
you enjoy part 1 of the Vascular Access series: Reducing risk and
increasing catheter longevity by Evan Alexandrou.