Central Line, Pediatric
A central line is a soft, flexible tube (catheter) that is used to give medicine or nutrition through a person’s veins. The tip of the central line ends in a large vein (vena cava) just above the person’s heart. Medicine given through the central line is quickly mixed with blood because the blood flow within this large vein is so great. This dilutes the medicine so it is swiftly delivered throughout the body.
A central line may be placed if:
A child needs long-term fluids or IV medicines, such as antibiotics.
A child needs nutrition delivered through a central line.
A child needs to have blood taken often for lab tests.
A child needs a blood transfusion.
A child needs chemotherapy.
TYPES OF
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This type of central line is inserted into a vein in the arm or scalp. A PICC looks like a regular IV but has a catheter that goes up the arm to the heart. The end of the catheter is outside the skin and can be used to give fluids or medicines and to draw blood. The PICC is taped in place on the arm, and the insertion site is covered with a bandage (dressing) to keep it clean and dry.
Tunneled venous catheter line. This type of central line is placed in a large vein in your child's neck, chest, or groin. A small incision is made over the vein and the catheter is advanced into the heart. This type of catheter is tunneled beneath the skin and brought out through a second incision. Both incisions are closed with a stitch (suture), tape, or skin glue. A dressing is placed over the incision where the catheter comes out through the
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These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
Check your incision area every day for signs of infection. Check for:
More redness, swelling, or pain.
More fluid or blood.
Warmth.
Pus or a bad smell.
Flushing and cleaning the catheter
Follow the health care provider's instructions about flushing and cleaning the catheter.
Before you flush or clean the catheter, wash your hands with soap and water.
When flushing or cleaning the catheter, put on a mask and have your child put on a mask.
Medicine
If your child has an implanted catheter, keep the incision areas dry until your child’s health care provider says it is safe to resume bathing and swimming. Most incisions need to be kept dry for at least 24 hours.
Give over-the-counter and prescription medicines only as told by your child’s health care provider.
General instructions
Follow the health care provider’s specific instructions for the type of device that your child has.
If your child has a PICC or tunneled catheter, do not let your child take baths or
According to an article by Timsit, J., et al. an estimated 5 million central venous catheters are inserted in patients each year. CBIs, most of which are associated with central venous catheters, account for more than 11% of all health-care associated infections. Additionally, more than 250,000 central-line associated blood stream infections also occur annually, with an estimated mortality rate of 12-25%. For patients within the intensive care unit, the numbers were even higher. Each episode significantly increases the patient’s hospital stay, as well as increasing costs from $4,000 to $56,000 per episode.
Woodrum, D.(1998). Practice standards for administration of Exogenous Surfactant. (Survanta). University of Washington Academic Medical Center. Available: Http://neonatal.peds.washington.edu/NICU-WEB/surf.stm Accessed: 2/08/01.
Then after threading a catheter through the needle, the anesthesiologist will withdraw the needle and leave the catheter i...
It is a closed system where the patient’s blood goes straight from the vein to the inside of the tube through the rubber stopper present at the entrance of the tube without the blood being open to the air. You can collect many tubes by using just a single venepuncture. There is three components required for the evacuated system: double pointed needle, plastic holder or adapter and evacuated sample tube. All constituents of the system ought to be from the same manufacturer to avoid difficulties with the correct needle fit and smooth placement and removal of tubes. The tubes used with the evacuated tube system for blood collection are known as evacuated tubes. With the evacuated tube, blood can be taken straight from the vein into the tube without exposing it to air (closed system). This reduces accidental contact with blood. These tubes have a preset vacuum based on the volume of the tube and the type and amount of additive used in the tube. When the rubber stopper of the tube is penetrated with the back-end of the needle in the needle/tube holder, blood is drawn into the tube from the vein by the vacuum. The vacuum in the evacuated tube permits the accurate amount of blood to go into it. Regardless of whether the anticoagulant in the anticoagulant tubes is a liquid, powder or spray on the inside of the tube, they must be allowed to fill to the finishing point. By not completely filling the
Central venous catheters (CVC) have various uses for patients in both the inpatient and outpatient settings. Their purposes range from administration of total parenteral nutrition, to administration of vesicant medication, to providing access to patients with poor peripheral vascularity, as well as hemodynamic monitoring (Alexandrou, Spencer, Frost, Parr, Davidson, & Hillman, 2009, p. 1485). Traditionally, insertion of CVCs have been performed by surgeons and internal radiologists. However, with the advancement of roles in nursing, there has been ongoing research supporting the pro stance on the practice of nurse-led central venous catheter insertion.
2013). Inappropriate use of urinary catheter in patients as stated by the CDC includes patients with incontinence, obtaining urine for culture, or other diagnostic tests when the patient can voluntarily void, and prolonged use after surgery without proper indications. Strategies used focused on initiating restrictions on catheter placement. Development of protocols that restrict catheter placement can serve as a constant reminder for providers about the correct use of catheters and provide alternatives to indwelling catheter use (Meddings et al. 2013). Alternatives to indwelling catheter includes condom catheter, or intermittent straight catheterization. One of the protocols used in this study are urinary retention protocols. This protocol integrates the use of a portable bladder ultrasound to verify urinary retention prior to catheterization. In addition, it recommends using intermittent catheterization to solve temporary issues rather than using indwelling catheters. Indwelling catheters are usually in for a longer period. As a result of that, patients are more at risk of developing infections. Use of portable bladder ultrasound will help to prevent unnecessary use of indwelling catheters; therefore, preventing
Intravenous therapy (IV therapy) is a method used to help the patient get better. Intravenous lines are put in for things as simple as delivering fluids when the patient is dehydrated to administering emergency lifesaving pharmaceuticals. As a patient or health care provider negative outcomes, such as having unneeded complications and jeopardizing patient comfort from an intravenous line is the last thing needed.
The aftercare of a tattoo is complex for the first couple of weeks. The tattoo cannot be soaked in water for 7-10 days, it cannot be exposed to the sun for 2-3 weeks, and it is detrimental that the skin is not picked or scratched in the area around the tattoo also. Also, the tattoo parlor that is chosen by a person determines the immediate aftercare instructions. Some say to remove the bandage right away. While others insist that you leave it on for two hours. This contains a risk since you don’t know which way is more accurate and safer. Body piercing is far easier to take care of in the weeks following the piercing. Depending on the body part all that is suggested is that for the first few weeks you apply a disinfection lotion or some other form of anti-bacterial liquid. Other than that piercings are free of care.
According to CDC, hand washing is the only best to reduce cross-contamination. As usually as wash my hand and don gloves in order to reduce cross-contamination. I followed evidence based practice when provided morning care and later in the afternoon when I provided perineal care for the patient.
There have been an incidents of prolonged hospital stay due to central line infections putting patients at risk for mortality, morbidity, and increase in medical cost. When central lines are placed at bedside or in interventional radiology, the inserter is required to document the steps and sterile procedure that took place in the electronic health record. Furthermore, with weekly and as needed dressing changes, nurses are required to use central line bundles and document what was used (ex: Chloraprep, biopatch, tegaderm, etc.) to track how the dressing was done. From these documented records, staff can gather data and measure the compliance of sterile procedure. Additionally, if a patient with a central line develops a fever without an unknown cause physician will order blood culture from the central line if catheter-related infection is suspected. If the test comes back positive, the team will initiate antibiotics immediately. By integrating electronic health records it can assist in CLABSI prevention strategies, raise the standard for best practices, and essentially reduce central line infections. With the quarterly results of CLABSI in our unit, CVC committee have re-educated the staff on appropriate dressing changes using sterile technique, transitioned to a different end
In the Article The Treatment, Roxana Robinson (2002), starts the story with a woman going down stairs into her “darken kitchen” so she can administer rocephin into her fragile veins. She then states, “that people take being well for granted, in some subliminal place you believe that you deserve your health” according to (Roxana Robinson, 2002). The writer believes that this is true, most people look down on sick people like if they inferior to you. However, this will never change due to people being naïve. The author is getting a pic line, an intervenes line that goes right above the heart, this is most effective due the veins not rupturing. Moreover, her treatment will be her salvation, she wants to be healthy and normal according to social
Place end of the catheter to the receptacle, using your dominant hand hold the catheter 2 to 3 inches from the tip and insert slowly
...f the clamps on the tubing to allow the IV solution to run freely. Slowly, decrease the flow of the solution to the appropriate rate as ordered by the physician. Using a small gauze pad, wipe away any excess blood or fluid on the surface of the skin. Then, using the pre-torn pieces of tape, secure the catheter hub and the IV tubing to the patient’s skin. Take extra caution not to kink the tubing. Once everything is secured, recheck the IV solution’s flow and then attend to the rest of your patients needs.
One day, this writer happened to see another nurse changing a Peripherally Inserted Central Catheter Line dressing. As a nurse leader, this writer asked the nurse why she is changing the dressing. The caregiver explained dressing changes can prevent infection to the site and there are lot of patients readmitted because of central line infections and subsequent complications. This nurse demonstrated good kn...
1. Nasogastric (NG): The most common route used in intensive care. Here a feeding tube