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Radiology
Central Venous Catheters
Built from Fundamentals of Diagnostic Radiology
What’s inside
5 sections · 63 slides
Overview
- What a central venous catheter is
- Why central access is needed
- A short history of the CVC
- 5 million
- Central venous catheters at a glance
Types of Central Venous Catheters
Four devices, each with a different risk and benefit profile
- Four types of CVC
- The four types of central venous catheters
- What a nontunneled CVC is
- When a nontunneled CVC helps
- Nontunneled CVC drawbacks
- What makes a CVC tunneled
- Tunneled dialysis catheter position
- Why the tunnel helps
- Tunneled CVCs in kidney failure
- What a port is
- Port reservoir and catheter position
- How a port is accessed
- When a port is the right choice
- What a PICC is
- PICC tip position
- PICC advantages
- PICC drawbacks
Venipuncture Technique and Anatomy
Internal jugular, subclavian, and femoral approaches
- The internal jugular vein approach
- Right versus left internal jugular
- Ultrasound-guided internal jugular access
- Ultrasound needle tip in the internal jugular vein
- The subclavian vein approach
- Subclavian versus internal jugular
- Subclavian access technique
- The femoral vein approach
- Femoral access technique
Potential Complications
Mechanical injury, infection, and occlusion
- Mechanical complications of placement
- Who is at higher mechanical risk
- Positioning errors and late problems
- Two definitions of CVC infection
- How CLABSI shows up
- How a catheter becomes infected
- Preventing CLABSI
- Coated catheters and antibiotics
- What CVC occlusion is
- Four causes of CVC occlusion
- Mechanical causes of occlusion
- Thrombosis and how it forms
- How common CVC thrombosis is
- When thrombosis causes symptoms
- Thrombosis complications and treatment
- Thrombolytics and PICCs
- How CVC thrombosis develops
- Chemical precipitate as a cause
- Preventing and treating TPN precipitates
- Drugs that precipitate
- Lipid residue occlusion
Device Selection
Matching the catheter to the infusion and its duration
- Peripherally incompatible infusate
- Peripherally compatible infusate
- Duration-based choices
- Difficult access and frequent blood draws
- Fluid resuscitation
- Key takeaways
- Suggested readings
- Suggested readings
- Suggested readings
- Suggested readings
- Brant and Helms' Fundamentals of Diagnostic Radiology