Same Day Nurse-Placed Vascath for Urgent ICU Dialysis describes how Vascular Wellness arrived at the bedside within three hours of request and helped an anxious patient, who needed extra time and assistance, to become calm enough for the nurse clinician to place a Vascath at the patient’s bedside so she could receive urgently needed hemodialysis.
Same Day Nurse-Placed Vascath for Urgent ICU Dialysis
– Clinical Case
An elderly patient was in a hospital ICU with lab values indicating the need for emergent dialysis. While blood cultures were pending, the care team determined that hemodialysis was needed right away, as her lab values suggested possible acute kidney injury and severe hyperkalemia (creatinine was 3.98, BUN was 78, and potassium was 8).
The facility contacted Vascular Wellness to place a large bore Vascath, or temporary dialysis catheter, for treatment.
Same Day Nurse-Placed Vascath for Urgent ICU Dialysis
– Diagnosis and Treatment
The advanced-trained vascular access nurse clinicians arrived at the facility a short while later and immediately focused on the patient, her care plan, and her medical history. Noticing that the patient was very nervous and clutching a stuffed animal, one of the Vascular Wellness nurses was able to focus on comforting and reassuring the patient while the other prepared for the procedure.
They assessed the patient’s vasculature and then inserted the Vascath safely, quickly, and without difficulty. A chest X-ray was read shortly after placement to confirm proper placement of the Vascath, and the dialysis technician was at the patient’s door and ready to begin treatment moments later.
The patient’s daughter thanked the vascular access nurses profusely for taking such good care of her mother. Despite the daughter being a nurse, she was extremely nervous about having such a large line placed and was worried that they were not taking her to an OR to place it. After seeing the advanced skills and how quick the process was from placing the order to her mother beginning dialysis, she told the clinicians that she hoped her mother’s care team would always call Vascular Wellness.
One of the Vascular Wellness nurses was able to check on the patient later, and she was doing very well. Her labs had returned to normal within 48 hours of beginning dialysis, and her oxygen requirements had decreased significantly.
By the Numbers:
1024 – Facility contacted Vascular Wellness to request a Vascath placement.
1215 – Vascular Wellness clinicians arrived at the facility the same day to place the large bore Vascath.
1300 – Vascath placement was complete, and X-ray was read to confirm placement.
1322 – Patient began hemodialysis using the Vascath.
Same Day Nurse-Placed Vascath for Urgent ICU Dialysis
Vascular Access Experts – Key Points
As Vascular Access Experts, Vascular Wellness pioneered nurse-placed Vascaths. Vascular Wellness’ nurse-placed Vascaths – and Permcaths – at the bedside have many advantages over the primary alternative of physician-placed devices in an Operating Room (OR) or Interventional Radiology (IR) Suite, including lower costs, faster hemodialysis treatment, and greater facility, physician, and patient satisfaction.
As physician-placed Vascaths and Permcaths are dependent on OR or IR room and medical personnel availability, they are typically not able to be performed the same day due to already scheduled procedures. Transportation within a facility or to another facility to get to the OR or IR room is costly and requires significant coordination of resources. Unlike nurse-placed procedures at the bedside where only local sedation is needed, physician-placed dialysis catheters require patients to fast prior to their procedure because of the need for anesthesia, which can cause additional delays in treatment. The use of anesthesia for surgical procedures in an OR adds significant resources and costs for the facility as well.
All of these moving parts can cause Delay Cascades for the patient, which are unnecessary delays in receiving critical care therapies that can result in medical complications, increased length of stay, worsening patient condition, waste of clinical resources, and more (see References below).
Our dedicated professional team of vascular access experts and specialists are trained, precepted, and certified in the placement of standard and advanced lines at the patient’s bedside. We arrive onsite, generally within three hours or less, with all the necessary equipment and supplies to perform vascular access procedures, whether it’s placing a standard or advanced line. Our value-added vascular access services support your facility by enabling you to avoid unnecessary transportation costs, utilize your medical resources efficiently, and deliver faster, safer therapy to your patient’s bedside. In addition, we promote teamwork internally and externally by either becoming an extension of your in-house team or operating as your outsourced provider, and all of our services are customized to meet our clients’ needs. Superior client services are an essential component of our partnerships, and our expert clinicians function as a bridge among all stakeholders: the patient, their family members, and the medical team.
References regarding “Delay Cascade”
- Heart & Lung. Volume 49, Issue3, Page 273-286, May-June 2020
- Journal of Infusion Nursing. 43(4): p222-228, July-August 2020
Journal of the American College of Emergency Physicians Open. 2020 Dec; 1(6): 1660–1668
Nurse Clinicians in Action is a spotlight series highlighting some of the interesting cases that Vascular Wellness clinicians have encountered and participated in treatment. These cases involve challenging situations or intriguing clinical presentations and may involve more than one Vascular Wellness clinician, as our clinicians have the ability to consult each other while in the field, as well as an on-call Clinical Administrator via a HIPAA (Health Insurance Portability and Accountability) compliant communication app. In addition, our extensive training program and diverse client base, including Level 1 Trauma Centers, Short Term Acute Care Hospitals, Long Term Acute Care Hospitals, and Skilled Nursing Facilities, provide our clinicians with a wide array of clinical experience and why we believe our clinicians, as a group, are the most experienced and best trained and supported vascular access clinicians.
If you require Vascular Access or want to learn more, speak to the team at Vascular Wellness today.
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Vascular Wellness provides:
(1) Comprehensive vascular access services to Mississippi, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, and Virginia; and
(2) Customized vascular access services to Arkansas, Delaware, Georgia, Tennessee, and West Virginia; and
(3) Support vascular access services to Kentucky.
Read more NCIA Patient Cases
Nurse Clinicians in Action stories highlight some of the interesting cases in which Vascular Wellness clinicians have encountered and participated as valuable team members.
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