![]() ![]() Catheter occlusions typically are associated with central VADs, but SPCs and midline catheters also can be affected. However, extended SPC and midline catheter use and patient-related risk factors can increase the challenge of preventing complications such as catheter occlusion, infection, infiltration or extravasation, skin injury, and phlebitis. Routine patient and peripheral VAD assessment is necessary to help ensure the patient doesn’t experience any of the many use-associated complications. ( See Peripheral VAD insertion-related complications.)ĭetecting and preventing care-, use-, and maintenance-related SPC and midline catheter complications require nursing vigilance. In addition to patient injury, these failures add to the overall financial impact for the patient and the healthcare organization. Catheter embolism can occur if the needle is reinserted into over-the needle catheters during cannulation, shearing or severing the catheter. ![]() Hematomas arise when an adjacent vessel is pierced or when the vein is penetrated through the vessel’s back wall. Vessel, nerve, and tissue damage can occur if the catheter isn’t adequately secured or if probing or multiple insertion attempts occur. Insertion-related infection can result from inadequate handwashing, workspace preparation, or skin antisepsis before insertion and failing to maintain aseptic technique throughout the process. Failures or complications at the point of insertion also may require additional insertions, increasing the risk for infection and vessel depletion. A poor insertion technique can place the patient at risk for insertion-related complications, including infection, tissue or vessel damage, therapy delay, and, rarely, catheter embolism. Skillful insertion of a peripheral VAD ensures patient safety and proper device functioning. Ongoing assessment to detect complication onset and to initiate corrective action and therapeutic management when complications occur are essential at each point. Nurses play an important role at specific points of care in the life of peripheral VADs: Midlines are catheters inserted into the upper arm via the basilic, cephalic, or brachial vein, with the internal tip located level to or near the level of the axilla and distal to the shoulder. SPCs are catheters less than 3″ (7.6 cm) long. SPCs and midline catheters are two devices used to obtain peripheral venous access. therapy, which can be life-sustaining or even life-saving, the devices also present a challenge when managing associated complications. Although the use of peripheral VADs allows patients to receive I.V. In the United States, at least 85% of hospitalized patients receive some form of I.V. A resurgence in the use of midline catheters provides yet another option for peripheral venous access. International data indicate that more than 1 billion SPCs are used annually in hospitalized patients. ![]() Short peripheral catheters (SPCs), commonly called “I.V.s,” are the most widely used VADs worldwide. PERIPHERAL vascular access device (VAD) use is widespread in inpatient and outpatient settings. Watch for an article on complications of central vascular access devices in our October issue.
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