PMID: 2110664Jun 1, 1990Paper

Advances in venous access devices and nursing management strategies

The Nursing Clinics of North America
R Wickham

Abstract

VADs are indicated for many persons who require reliable long-term venous access. Nontunneled, tunneled, and venous access ports are constructed of silicone or polyurethane, the most biocompatible materials identified thus far. These devices are inserted in a similar fashion and are extremely versatile. Although VADs represent a major advance in catheter technology, they are not without problems. The most serious and frequently reported complications include infection, thrombosis, and extravasation. Catheter occlusions are another frequent problem, and may be caused by clotted blood or precipitated drug within the catheter. Nursing care centers on prevention and intervention to remove the occlusion. Catheter-related infections may occur at one or more points along the catheter. The most serious are those occurring in the tunnel or as a result of a mural or catheter-tip thrombus. Normal skin flora are most commonly cultured with catheter-related infections. These organisms may be introduced into the body through the catheter hub or less often by migrating along the external catheter. Infections differ in their severity, prognosis, and treatment. Actions to minimize risk (scrupulous care and patient teaching), prompt recognition,...Continue Reading

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