Central Venous Catheters by Andy Bodenham, Helen Hamilton

By Andy Bodenham, Helen Hamilton

This booklet addresses all of the concerns a sufferer may well adventure sooner than receiving a VAD. choice of apparatus, functional elements of process, the professionals and cons of many of the veins, and alterations of procedure for definite conditions are tested. Covereage additionally contains the jobs performed via radiologists, anaesthetists, surgeons, nurses, and different crew memebers. during the chapters a reference is made to the IV treatment criteria released via the Royal collage of Nursing IV treatment discussion board in 2003. each one bankruptcy is proof dependent and entirely referenced.

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This digital subtraction venogram in an elderly patient shows a tortuous SVC. It may be difficult to achieve passage of guidewires or good tip position in such cases. Where should the catheter tip lie? 9 A Hickman catheter has been passed by the left subclavian route into the SVC. The catheter tip is marked with an arrow. The patient has gross mediastinal shift to the left following a previous left pneumonectomy, some years previously. The position of the catheter in the great veins may cause confusion unless the abnormal anatomy is appreciated.

There is blockage of the right and left subclavian veins (arrows) following sclerosant chemotherapy. Contrast refluxes into the neck veins and passes centrally through numerous collaterals. 8 Great veins do not always run the straight course depicted in anatomical texts. This digital subtraction venogram in an elderly patient shows a tortuous SVC. It may be difficult to achieve passage of guidewires or good tip position in such cases. Where should the catheter tip lie? 9 A Hickman catheter has been passed by the left subclavian route into the SVC.

The risk of arterial puncture is greater for the femoral vein than for the internal jugular vein, and less for the subclavian vein (McGee 2003, Hall 2005). However, this ranking is reversed when the consequences of arterial puncture are considered. The consequences of subclavian arterial puncture (or even tearing of the subclavian vein) can be considerable as the vessels cannot be compressed manually from the outside of the body because they lie under the clavicle and leads to haemothorax in severe cases.

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