Book contents
- Frontmatter
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- SECTION 1 Admission to Critical Care
- SECTION 2 General Considerations in Cardiothoracic Critical Care
- 8 Managing the airway
- 9 Tracheostomy
- 10 Venous access
- 11 Invasive haemodynamic monitoring
- 12 Pulmonary artery catheter
- 13 Minimally invasive methods of cardiac output and haemodynamic monitoring
- 14 Echocardiography and ultrasound
- 15 Central nervous system monitoring
- 16 Point of care testing
- 17 Importance of pharmacokinetics
- 18 Radiology
- SECTION 3 System Management in Cardiothoracic Critical Care
- SECTION 4 Procedure-Specific Care in Cardiothoracic Critical Care
- SECTION 5 Discharge and Follow-up From Cardiothoracic Critical Care
- SECTION 6 Structure and Organisation in Cardiothoracic Critical Care
- SECTION 7 Ethics, Legal Issues and Research in Cardiothoracic Critical Care
- Appendix Works Cited
- Index
10 - Venous access
from SECTION 2 - General Considerations in Cardiothoracic Critical Care
Published online by Cambridge University Press: 05 July 2014
- Frontmatter
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- SECTION 1 Admission to Critical Care
- SECTION 2 General Considerations in Cardiothoracic Critical Care
- 8 Managing the airway
- 9 Tracheostomy
- 10 Venous access
- 11 Invasive haemodynamic monitoring
- 12 Pulmonary artery catheter
- 13 Minimally invasive methods of cardiac output and haemodynamic monitoring
- 14 Echocardiography and ultrasound
- 15 Central nervous system monitoring
- 16 Point of care testing
- 17 Importance of pharmacokinetics
- 18 Radiology
- SECTION 3 System Management in Cardiothoracic Critical Care
- SECTION 4 Procedure-Specific Care in Cardiothoracic Critical Care
- SECTION 5 Discharge and Follow-up From Cardiothoracic Critical Care
- SECTION 6 Structure and Organisation in Cardiothoracic Critical Care
- SECTION 7 Ethics, Legal Issues and Research in Cardiothoracic Critical Care
- Appendix Works Cited
- Index
Summary
Introduction
With very rare exceptions, all patients undergoing critical care will, at some stage during their admission, require an indwelling venous catheter or cannula for fluid and drug administration, invasive monitoring and therapeutic intervention. So ubiquitous is the role of venous access in current medical practice that it is rarely given much consideration in even the most comprehensive textbooks.
This chapter reviews the various sites of venous access, devices in common use, methods of insertion and removal and common complications.
Sites of venous access
Anatomical sites are usually divided into two categories: peripheral and central. Short-term (i.e., 1–3 days) access for infusions of crystalloids, colloids, blood products and nonirritant drugs can be achieved using small to medium sized (e.g. 22- to 14-G) cannulae in a peripheral (i.e., arm and leg) vein. Patients with ‘poor’ peripheral veins and those requiring long-term (>4 days) venous access, invasive monitoring, inotropic or irritant drugs (e.g. cytotoxic agents), intravenous feeding or therapeutic intervention typically require central venous access with larger (7- to 9-Fr) devices with one or more lumens. Placement of a ‘peripherally inserted central catheter’ (PICC) allows delivery to a central vein via a long (30- to 55-cm) indwelling catheter.
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- Information
- Core Topics in Cardiothoracic Critical Care , pp. 70 - 79Publisher: Cambridge University PressPrint publication year: 2008