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.
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