Nursing care to patients percutaneouswithand/or medium to long- term central venous catheter
What is a CVC?
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
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What is a CVC?
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
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Pathways and validations:
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
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Indications for the placement of the CVC
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
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Classification of the different types of catheter (1)
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
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Classification of the different types of catheter (2)
PARTIALLY IMPLANTABLE DEVICES OR EXTERNAL TUNNELLED SYSTEMS
GROSHONG HICKMAN and BROVIAC
TOTALLY IMPLANTABLE DEVICES (PORTS)
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
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NON-VALVED
VALVED
HICKMAN™ – BROVIAC™ CVCs
single, double and triple lumen
Connector
Attached clamps
Protective clamping sleeve
Antimicrobial cuff
Tissue ingrowth cuff
Catheter
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
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GROSHONG™ CVC single and double lumen
Winged connector Protective sleeve
Rounded tip
Groshong valve
Suture wing
Red point
Antimicrobial cuff
Tissue ingrowth cuff
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter 9
CATETERE GROSHONG™
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
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Section of the single, double and triple lumen CVC
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
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FUNCIONING OF THE GROSHONG VALVE
Aspiration Negative pressure Infusion Positive pressure Closed Neutral pressure Nursing care to patients with percutaneous and/or medium to long-term central venous catheter 12
ADVANTAGES OF A VALVED CVC
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter 13
PARTIALLY IMPLANTABLE CVCs
DISADVANTAGES ADVANTAGES
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
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TOTALLY IMPLANTABLE CVCs
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
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PORT
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
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CVC
PORT,
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
type
with reservoir of different shapes, dimensions and materials, with single or double lumen.
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CVC type PORT
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
CVC type
PORT
Septum
Skin surface
Catheter
Blood vessel
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Huber and Gripper needles
Huber (A) and Gripper (B) needles with offset non-coring tip preserving the integrity of the port septum. A
Second access line
Removable handle
Bending-resistant tube
Large and padded base of the needle
Non-coring and non-siliconized needle
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
B
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CVC: PORT
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
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TOTALLY IMPLANTABLE CVCs DISADVANTAGES ADVANTAGES
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
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PREPARATION FOR THE PLACEMENT OF THE CVC
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
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CONTRAINDICATIONS
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
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INFORMED CONSENT
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
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THE ROLE OF THE NURSE
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
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CVC: PLACEMENT SITES (1)
Site Superficial access
Upper body
• External jugular vein
• Cephalic vein
• Basilic vein
• Axillary vein
Deep access
• Internal jugular vein
• Subclavian vein
Lower body
• Saphena vein
• Femoral vein
Other (special cases)
• Umbilical vein
care to patients with percutaneous and/or medium to long-term
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Nursing
central venous catheter
CVC: PLACEMENT SITES (2)
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter 27
CENTRAL PERIPHERAL
Insertion point
Catheter tunnelled under the skin
Polyester cuff
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
Exit point
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CVC: CANNULATION METHOD (1)
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter 29
CVC: CANNULATION METHOD (2)
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
SELDINGER METHOD
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There is no best catheter and best placement technique; situations are different and difficult to generalize, thus making a complete standardization impossible.
Therefore, the team must be able to use different materials and techniques, to be adapted on a case by case basis.
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter 31
THE ROLE OF THE NURSE IN THE ANAESTHESIA SERVICE (1)
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter 32
THE ROLE OF THE NURSE IN THE ANAESTHESIA SERVICE (2)
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter 33
THE ROLE OF THE NURSE IN THE ANAESTHESIA SERVICE (3)
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter 34
NURSING PLAN IN THE OPERATING UNIT
Nursing care to patients with percutaneous and/or medium to long-term central venous catheter
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