2015 Trumbull Memorial Hospital Demo

Central Venous Catheter Access Central Venous Catheter Access

Subcutaneous Venous Access Ports  Never access without the appropriate needle (Huber needle)  Never access without the appropriate training  This protocol is not for subcutaneous devices

Clinical Considerations  Failure to use aseptic technique could result in sepsis, hemorrhage, or loss of access site.  Diligently wipe all accesses with alcohol preps prior to every use.  Be sure to unclamp/ reclamp and uncap/ recap all sites appropriately.  Many non-intravenous routes are available. Consider an alternative route of administration.  If the device is used prehospitally, the hospital will likely need to replace it.

Universal Patient Assessment

Assess need to access the external central venous catheter.

 Critical Patient  Cardiac Arrest

Watch for Signs of Infiltration  Swelling  Redness  Pain  Leakage/drainage

Uncap and diligently clean the intended port and maintain sterility throughout the procedure

Connect syringe and unclamp the intended lumen

Do not access dual lumen ports intended for hemodialysis unless patient is in cardiac arrest and you have no alternative.

Draw back 10mL of blood from intended port and set syringe aside

Failure to properly handle and reclamp the device will lead to an air embolism

Flush port with 10mL of normal saline to ensure patency

Administer intended medications

Flush port, reclamp , and recap . Monitor site for complications.

27

EMR

EMT

AEMT

Paramedic

Extended