Central Venous Access Devices
Care and Management

Central venous access devices (CVADs) are used within a variety of areas in both hospital and community health care settings to administer blood or fluids, to provide long term access for repeat transfusion of blood or blood products, chemotherapy, parenteral nutrition and antibiotic therapy, and to provide immediate access in emergency situations.

Central venous access devices (CVADs) are used within a variety of areas in both hospital and community health care settings to administer blood or fluids, to provide long term access for repeat transfusion of blood or blood products, chemotherapy, parenteral nutrition and antibiotic therapy, and to provide immediate access in emergency situations."Central Venous Access Devices" is a practical guide to the care and management of CVADs aimed at student nurses, newly qualified nurses and more experienced nurses who are unfamiliar in dealing with these devices. "Central Venous Access Devices" addresses patient assessment and education, relevant anatomy and physiology, appropriate device selection, and guidelines on insertion, follow-up care and management of CVADs. Each category of CVAD - including peripherally inserted central catheters, non tunnelled central venous catheters, skin tunnelled catheters and implanted ports - is explored in turn. Concluding chapters explore hazards of insertion, prevention and management of complications, and patient perspectives on living with a CVAD.

Introduction. 1. What is a CVAD?. Definition. Uses. Advantages and disadvantages. Patient assessment. General aspect of Insertion - by whom, where, infection control issues such as skin cleansing etc. Issues related to consent. 2. Peripherally inserted central catheters (PICCs). Definition. Types. Uses. Advantages and disadvantages. Insertion. Immediate care. Follow up care. Removal. 3. Non tunnelled short-term central venous catheters. Definition. Types. Uses. Advantages and disadvantages. Insertion. Immediate care. Follow up care. Removal. CVP monitoring. 4. Skin-tunnelled catheters. Definition. Types. Uses. Advantages and disadvantages. Insertion. Immediate care. Follow up care. Removal. 5. Implanted ports. Definition. Types. Uses. Advantages and disadvantages. Insertion. Immediate care. Follow up care. Removal. 6. Management of CVADs. Securement and dressing. Maintaining patency. Prevention of infection. Taking blood samples. 7. Hazards of insertion. Pneumothorax. Definition. Prevention. Management action. Haemorrhage. Definition. Prevention. Management action. Air embolism. Definition. Prevention. Management action. Infection. Definition. Prevention. Management action. Thrombosis. Definition. Prevention. Management action. 8. Managing complications. Catheter damage. Catheter malposition. Catheter occlusion. 9. Patient Perspective. Patients view of CVADs. Education and training - examples of teaching programme. Patients information sheets - examples. . Appendix 1: The AccessAbility Decision-Making Model. Appendix 2: Consent form for PICC insertion. Appendix 3: Sources of Information