Internal Jugular Vascular Access Cases highlight some of the interesting Nurse Clinicians in Action cases that Vascular Wellness clinicians have encountered and participated in treatment. Having the ability to place Advanced Lines such as Internal Jugulars enables our nurse clinicians to assess each situation and patient, collaborate with the medical team, and place the most clinically appropriate line. Advanced Lines is just one way that Vascular Wellness provides the most comprehensive Vascular Access solution at the bedside.
Mastectomy and PICC Line can be Unsafe Combination | NCIA-05
Internal Jugular Vascular Access Cases: A physician ordered a PICC line and a consult with Vascular Wellness for a bilateral mastectomy patient with lymph node removal who needed multi-lumen access for antibiotics and Total Parenteral Nutrition (TPN). After reviewing the patient and medical records, the Vascular Wellness clinician recommended a Small Bore Internal Jugular (IJ) line as the safest option, because lines placed in arms of bilateral mastectomy patients with lymph node removal were contraindicated and could lead to lymphedema now or in the future. The managing physician agreed and revised the order. The patient was hesitant about having a line inserted in her neck instead of her arm, but the clinician and physician explained the importance and positive clinical impact of using the IJ, as well as the process. The patient’s fears were alleviated, and she was pleasantly surprised at how fast the procedure was performed and how comfortable she was during the procedure.
Vascular Access for Surgical Rehabilitation Patient | NCIA-30
Internal Jugular Vascular Access Cases: A patient in a Rehabilitation Facility was recovering from bowel surgery and had a potential surgical site infection and bilateral swelling due to post-operative restraints. Because the patient’s poor peripheral veins made vascular access difficult, the facility could not obtain blood lab samples to confirm the suspected infection. Vascular Wellness was consulted to place a midline for antibiotic IV therapy. Upon arrival and evaluation of the patient and medical history, the Vascular Wellness clinician found co-morbidities and bilateral swelling in the arms after an ultrasound assessment of both arms. Understanding the prescribed line would create additional complications, she discussed her concerns with her Vascular Wellness colleagues. She suggested a diagnostic ultrasound to rule out a possible DVT in the right arm and shared that a midline was no longer preferred due to the risk of secondary DVT in the left arm if placed there. The LIP requested an ultrasound-guided left arm PIV, but this was not possible due to vein size and swelling. Ultimately, the clinician recommended an Internal Jugular central line, and the care team agreed to proceed with an IJ catheter, which would significantly reduce the risk of a secondary DVT. The insertion procedure and blood collection were performed without difficulty, allowing for rapid delivery of the prescribed therapy.
Internal Jugular Line When Upper Arm Infections | NCIA-06
Internal Jugular Vascular Access Cases: A woman in her twenties suffered from bilateral upper extremity infections caused by orthopedic hardware. The hardware was surgically removed, and the patient required long-term IV antibiotics to eliminate the infection. The managing physician ordered a PICC line with Vascular Wellness, however, upon assessment of the patient’s condition, the Vascular Wellness clinician determined a PICC would be contraindicated due to the location of incisional wounds and infection. Instead, a Small Bore Internal Jugular (IJ) line was recommended to avoid the compromised area, and the medical team agreed. The Vascular Wellness clinician placed an ultrasound-guided single-lumen IJ at the patient’s bedside. This procedure allowed the initiation and completion of treatment while avoiding the area of contamination, which could have contributed to line infection.
Internal Jugular Vascular Access Cases: Key Points
Our specialized training of advanced lines such as Internal Jugulars, including semi-annual skill verification, provides our clinicians the skills, knowledge, and confidence to manage even the most challenging cases.
Vascular Wellness nurses are Vascular Access Board Certified (VA-BC) and trained, precepted, and certified in the placement of standard and advanced lines at the patient’s bedside, making the breadth of our Vascular Access services exceptional and unique.
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As Vascular Access Experts, Vascular Wellness is the largest provider in the southeast of comprehensive vascular access services, including standard and advanced line placement, pediatrics, program management, education, training, and infection control and prevention to all healthcare settings such as Tertiary Hospitals, Community Hospitals, Long-Term Acute Care Hospitals, Skilled Nursing Facilities, Hospice, and At-Home. We support a 98+% Success Rate with 0% insertion-related infection rate across all lines, with an average response time of 3 hours. We help our clients improve patient outcomes, enable faster therapy, reduce costs, infections, and readmissions, decrease hospital length of stay, and eliminate transportation.
NURSE CLINICIANS IN ACTION case summaries involve challenging situations or intriguing clinical presentations where Vascular Wellness was able to create clinically appropriate access promptly, minimize sticks, and place the right line at the right time, the first time.
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Vascular Wellness provides comprehensive, quality, timely, and innovative vascular access services, including standard and advanced line placement, pediatrics, program management, education, training, and infection control and prevention to all healthcare settings such as Tertiary Hospitals, Community Hospitals, Long-Term Acute Care Hospitals, Hospital at the Home Programs, Skilled Nursing Facilities, Surgical and Outpatient Centers, Hospice, and At-Home care. We support a 98+% Success Rate with 0% Insertion-Related Infection Rate across all lines, with an average response time of 3 hours. We help our clients improve patient outcomes, enable faster therapy, reduce costs, infections, and readmissions, decrease hospital length of stay, and reduce transportation expenses.
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