CVADs/PICC line (central venous access device/peripherally inserted central catheters)

Indications
1. IVABs long term
2. Multiple IV therapies
3. Haemodynamic monitoring
4. Access for Blood
5. TPN
6. Acutely unwell patient
7. Poor IV access
8. Chemo
9. Highly vesciant medication
10. Critical care units/ patients
1-4 lumens
Treat each lumen as dedicated line - drugs do not 'mix'
Positive pressure devices
1. Flush 10mL syringe, DO NOT clamp
Complications
1. Thrombosis
2. Blood stream infection (CRBSI)
3. Local irritation
4. Air embolism
5. kinks in the line
6. Disconnection
7. Pulled out/ change in length
Bio patch- blue to the sky
Neutral pressure devides (normal bung)
1. Flush + CLAMP
To ensure the device is "pressure locked", use a 10mL syringe with 8mL Push Flush post all IV
1. Even after IVF infusion flush - A BURETTE 'FLUSH' is not the same thing - the line will occlude if it is not "pressure locked" with a 10 mL syringe
Within EN Scope
1. Competency must be achieved (theory and practical)
  1. https://www.clinicalkey.com.au/nursing/#!/content/skills/63-s2.0-GN_44_11
    1. PICC-Related Thrombosis: Pathophysiology, Incidence, Morbidity and the Effect of Ultrasound-Guided Placement Technique on Occurrence in Cancer Patients Elen Hughes, Ms Meinir, RGN, PGCE, MSc., Journal of the Association for Vascular Access, Volume 16, Issue 1, 8-18 Copyright © 2011 Association for Vascular Access
2. Ability to manage CVADs and PICCs dependant on hospital policy and procedure. Some instititions you can look after the, some you can't.

Resource summary

	Created by TAFE Southbank Nursing over 6 years ago

	Copied by Sam A over 6 years ago

	Copied by Tafe Teachers SB over 6 years ago