Advanced IV Access

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Advanced IV Access
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Existing Central Lines are very easy to access.

• Arizona Paramedics may access these with proper
  training and with proper Base Medical Control.
• Different types of Existing Central Lines
• 1. Hickman, Broviac,
• 2. Groshong
• 3. Port-A-Cath
• 4. PICC

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• Remember that these are CENTRAL LINES and must be
  treated with very ASEPTIC Technique.

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• Used for
• Chemotherapy, Blood, TPA, Heparin, Other
  medications
• Advantages
• Medication delivered into large vessel
• Medication does not damage vessels
• Patient does not need repeated IV access needle
  sticks
• Disadvantages
• Requires surgical insertion
• Pneumothorax at time of insertion
• Bleeding at site
• Hematoma at site
• Infection
• Site needs continual care and dressings
• Port and tubing outside on chest/neck
• Thrombosis formation

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Potential Problems

• Hematoma/Bleeding at site
• Apply direct pressure
• Infusion slow/sluggish
• Check for kinked tubing
• Reposition patient
• Raise arm on same side as catheter
• Roll patient to opposite side
• Have patient sit up
• Have patient take deep breath or cough
• (Be creative) Try whatever comes to mind!!!

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Potential Problems

• Infiltration/Extravasation
• Clamp tubing
• Air embolism (respiratory distress)
• Clamp catheter immediately and turn patient on
  left side with head down so air enters the right
  atrium and pulmonary artery. Maintain this
  position for 20-30 minutes.

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PORT-A-CATH

• REQUIRES A SPECIAL NEEDLE FOR ACCESSING called a
  (HUBER NEEDLE)-Non Coring Needle
• 1 Wash hands thoroughly. Put on gloves
• Aseptic technique is to be used
• Gather Supplies (Huber needle, syringe, IV
  Solution)
• Open Huber Needle, flush it with NS to purge air.
• Locate the portal septum by palpation, cleanse
  skin with betadine then alcohol. Inform patient
  that you will be inserting needle. Insert needle.
• Release the clamp on needle tubing and flush with
  1cc NS
• Withdraw 8-10cc of blood, clamp tubing, remove
  syringe and discard blood.
• Unclamp tubing and run IV Solution at desired
  rate.
• Place a sterile 2X2 gauze pad underneath the hub
  of the needle.
• Place transparent dressing over the needle.

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Huber Needle
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Any Questions?