Many in our community receive medical treatment through a process called vascular access. In this blog, we will cover the following topics:
What is Vascular Access?
Vascular access is a quick, direct method of enabling the entry or removal of a device or chemicals from an individual’s bloodstream. This procedure allows medical providers to easily access the veins of a patient’s body.
Surgeons use a number of different vascular access methods. These methods can be used on both adults and children and may be used for IV antibiotic treatment, chemotherapy, long-term IV feeding and blood transfusions. Prolonged vascular access can be beneficial to the patient because it avoids countless repeated needle punctures, providing a less painful way for patients to receive long-term treatment.
What is a Vascular Access Device?
A vascular access device (VAD) is a device that is inserted into veins through central or peripheral vessels for therapeutic or diagnostic purposes. These include central venous pressure reading, blood sampling, total parenteral nutrition, administration of medicine and fluids, and blood transfusions.
Types of Vascular Access
AV Fistula
An arteriovenous fistula is an unusual passageway created by surgeons between an artery and a vein.The arteries help carry blood from the heart to the body, while the veins do the opposite, carrying blood from the body back to the heart. The AV fistula tends to be placed in the forearm or upper arm, where it causes both extra pressure and blood to flow into the vein. The larger vein makes for easier and more reliable access to blood vessels. An AV fistula helps to provide sufficient blood flow for dialysis, lasts longer than other types of vascular access, and is less likely to get infected or cause blood clots. However, the AV fistula frequently requires at least two to three months to mature before it could be used for hemodialysis.
AV Graft
The AV graft is a hollow looped, synthetic tube that connects the artery to a vein. It is an alternative vascular access method that many healthcare providers turn to if an AV fistula is not an option. The graft is usually placed in the arm, but could also be placed in the leg if required. The graft is usually ready to be used two to three weeks after the surgery. One risk of using a graft is that it is more prone to infection and clotting than an AV fistula because it is a foreign object in the vessel. Blood clots can develop and block the flow of blood through the graft, but if well cared for a graft can last several years.
PICC Line
PICC stands for Peripherally Inserted Central Catheter. A PICC line is a special type of catheter, it is a thin, hollow plastic tube that allows vascular access for IV treatments such as antibiotics, chemotherapy, and pain medications. The catheter is placed peripherally (in an arm vein) with the tip of the catheter located centrally, as in a central vein in the body. PICC lines are placed when patients need IV treatments for a duration of weeks to months. This method is often used for more temporary vascular access.
Temporary Venous Catheter
A temporary venous catheter is a long hollow tube that is inserted into one of the central veins in the neck, chest, or leg near the groin. This catheter is designed to stay in for a short period of time. A Temporary Venous Catheter is only used for short-term hemodialysis. Once the tube exits the body it is split into two tubes that have caps connecting the line that carries blood to the dialyzer and the blood back from the dialyzer to the body. Venous catheters are not suggested for long term use, as they can cause blood clots, infection or even vein scarring that causes veins to narrow. However, this method allows immediate hemodialysis which is necessary in some urgent cases.
Common Problems and Complications
There are many risks associated with vascular access which may lead to prolonged treatment or even surgery. Common problems with vascular access include the potential bloodstream infection and blood clots which could reduce blood flow. Both infection and low blood flow tend to happen more frequently in AV grafts and Temporary Venous Catheters than in other methods of vascular access. Low blood flow caused by AV grafts may require an angioplasty to widen the narrow veins. Temporary Venous Catheters are most likely to cause clotting problems and infection, but antibiotics are often used to prevent catheter-related infection. Other medications such as Warfarin or other blood thinners may be used to keep blood from clotting in the catheter.
Preventing Infections
- Regular checks with health care providers to detect any signs of infection or other problems.
- Keep the vascular access site clean at all times, and follow all instructions carefully given by health care providers.
- Looking out for redness
- Allow no form of heavy lifting or applied pressure to the site to prevent complications
- Avoid wearing jewelry and tight clothes
- Avoid sleeping with the access arm under the head or body.
Maintaining breathability and visibility is important for caring for a vascular access site and preventing complications. Care+Wear PICC line covers were designed with these guidelines in mind and provide an antimicrobial, comfortable, washable option and a mesh window for maximum breathability and visibility.
Reach out to us
We are committed to providing products that help patients with vascular access feel comfortable and care for their access sites. We are always excited to share more on topics that interest you, so please contact us with comments or suggestions.
Fiona Manonn
January 20, 2022
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