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What is the difference between a PVAD and 1. Location of catheter tip
CVAD? 2. Insertion site
3. Dwell time
4. Types of infusions
5. Who can insert
6. Blood sampling
7. Home IV therapy
8. Risk of complications
9. Cost
10. Time for insertion and care
Location of catheter tip for PVAD vs CVAD Periphery vs SVC
Location of insertion site for PVAD vs CVAD - hand to elbow-distal veins of the arm or in the foot
- Jugular, cephalic, basilic, brachial, subclavian, femoral
Catheter dwell time for PVAD vs CVAD - change 72-96 hours or prn
- PICC = 1 year
- non-tunnelled = 1 week
- tunnelled = 3 years
- IVAD = 8 years or # of punctures
Types of infusions for PVAD vs CVAD - short-term
- chemo, TPN, increased osmolality or decreased pH, higher
irritant, cost consideration
Who can insert PVAD vs CVAD - RN, LPN
- IV nurse, surgeon
Blooding sampling for PVAD vs CVAD - no
- yes
, Home IV therapy for PVAD vs CVAD - no
- Yes
Risk of complications for PVAD vs CVAD - infection, phlebitis, thrombophlebitis, fluid overload, arterial
puncture, hemorrhage, extravasation
- same as PVAD + air embolism, pneumothorax, hemothorax,
arrhythmia, horners syndrome
valved VAD - A venous access device with an internal (integrated) valve or
device located at either the proximal or distal end. The valve
allows infusion and aspiration through the VAD, but it remains
closed when not in use, thus preventing back flow and
providing a safety mechanism. There is no need for routine
clamping or heparinizing
Non valved VAD A venous access device without an internal (integrated) valve
or device. Has a clamp to prevent reflux or black flow of fluid
contents or blood. Require a heparin lock to keep patent (eg.
heparin 100 units/ml prefilled syringes)
What is the benefit of multi-valved lines? - If more than one lumen, usually at least one lumen is a
What is the purpose of the different lumens? different gauge (eg. 19g, 20g and 20g).
- May administer multiple medications/treatments at the same
time.
- May administer multiple incompatible medications at the
same time.
- Multi-lumen catheters have different port openings at end of
catheter.
- Each lumen often has a different color hub (eg. red is often
used for blood, and white is often used for TPN (but varies
between manufacturers).
Flush technique of CVADS Need to flush before and after administration, flush at same
rate as med administration (initially to assess patency, post to
ensure complete dose of medication has entered the
bloodstream)
Need to flush between medications;
Use a turbulent (push-pause) flush technique
Types of CVAD's (Central Venous Access 1. PICC
Devices) 2. CVAD - non-tunneled
3. CVAD - tunneled
4. IVAD