Care and Maintenance to Reduce Vascular Access Complications

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Care and Maintenance to Reduce Vascular Access ComplicationspH: Degree of acidity or alkalinity of a substance (RCN, 2003).Phlebitis: Inflammation of a vein; may be accompanied by pain, erythema, edema, streak formation and/orpalpable cord; rated by a standard scale (RCN, 2003).Peripherally inserted central catheter (PICC): Soft, flexible, central venous catheter inserted into an extremityand advanced until the tip is positioned in the lower third of the superior vena cava (RCN, 2003).Personal protective equipment (PPE): Specialized clothing or equipment worn by an employee for protectionagainst an infectious hazard (e.g., gloves, masks, protective eyewear, gowns). General work clothes (e.g.,uniforms, pants, shirts or blouses) not intended to function as protection against a hazard and are notconsidered to be personal protective equipment (CNO, 2004).Post-infusion phlebitis: Inflammation of the vein occurring after the infusion has been terminated and thecatheter removed, usually identified within 48 hours after removal.Proximal: Closest to the centre of midline of the body or trunk, or nearer to the point of attachment; theopposite of distal (RCN, 2003).PSI: Pounds per square inch; a measurement of pressure; 1 PSI = 50 mm/Hg (Weinstein, 2001).Routine Practices: Chosen by Health Canada to emphasize that it is the level of care that should be providedfor all clients at all times. It incorporates previous precautions against blood borne pathogens (UniversalPrecautions) but with the addition of body fluid precautions. The focus is on prevention.Safety device system/Safety engineered device: Engineered physical attribute of a device that effectivelyreduces the risk of blood borne pathogen exposure (RCN, 2003).Standard Precautions: Is the term used by the U.S. Centers for Disease Control and Prevention and is used for whatin Canada is known as Routine Practices. The two don’t differ in principle, however; “Standard Precautions”were written for Acute Care Settings and may not be appropriate for community care practice settings.Tunneled catheter: Vascular access device whose proximal end is tunneled subcutaneously from theinsertion site and brought out through the skin at an exit site (see Appendix D) (INS, 2000).Thrombolytic agent: Pharmacological agent capable of dissolving blood clots (RCN, 2003).Vesicant: Agent capable of causing injury when it escapes from the intended vascular pathway intosurrounding tissue (RCN, 2003).Universal Precaution: An outdated term used for precautions against blood borne pathogens. Refer toRoutine Practices.66
Nursing Best Practice GuidelineAppendix C: Vein Anatomy & Blood FlowRates for Peripheral Site SelectionVenous blood flow rates nurses will consider when selecting a peripheral site include:■■■Dorsal arch (metacarpal veins) diameter varies, with flow rate 10mL/minuteFlow rate in upper arm, just below the axilla, is approximately 250 mL/minuteFlow rate in hand and lower forearm ranges from 10-95 mL/minuteCephalic Vein(250 mL/min) Basilic Vein(250 mL/min)Accessory Cephalic Vein(95 mL/min) Median Cubital Vein(95 mL/min)Median Vein(40 mL/min)Cephalic Vein(40 mL/min)Basilic VeinMetacarpal Veins(10mL/min)67Illustrated by: Nancy A. Bauer, BA, Bus. Admin, RN, ET.
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Care and Maintenance to Reduce Vascular Access Complications

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