Vascular Access Patient Education 

Vascular Access Patient Education provides general information about vascular access for anyone looking to learn more and describes Procedures, Devices, Preparation, Risks, and Device Care.  In addition, we provide specific information for Vascular Access Midline Patients, PICC Patients, and Internal Jugular Central Line Patients, including care and maintenance of such lines.  We plan to continue to update our Vascular Access Patient Education page based on frequently asked questions (FAQs) from our patients and readers.   

Vascular Access Patient Education

 FAQ’s about Vascular Access Procedures and Care & Maintenance

Vascular Access Patient Education | Procedures

What is a vascular access procedure?

A vascular access procedure involves the insertion or placement of a vascular access device (i.e., a sterile tube commonly referred to as a catheter) into a blood vessel allowing for access to the cardiovascular system via the vein.  The underlying ailment, disease, or medical need for access, along with the length of time a patient needs vascular access for treatment, the use of the vascular access such as the delivery of medication or fluids, and the patient medical history are all factors in determining which vascular access device is most clinically appropriate, and the procedure used to insert the such device.  A vascular access procedure ranges from a basic IV to a small or large bore central line via the Jugular or Femoral vein, and depending on the procedure, can be performed by nurses or doctors.  As it is an invasive procedure, a vascular access procedure requires a physician’s order and patient consent before being performed.

Why is a vascular access procedure needed?

Patients who require ongoing therapy such as intravenous medications, including antibiotic treatments and other fluids, long-term nutritional support, hemodialysis, chemotherapy, or repeated blood draws can benefit from a vascular access procedure.

Vascular Access Patient Education | Devices

What are vascular access devices?

There are several different types of vascular access devices and the type of vascular access device you receive depends on your unique situation. Your doctor will prescribe for you the type of device you require based on the therapy required, the length of a time your device needs to stay in place, and your medical history.  Vascular access devices include Basic or Extended Dwell Peripheral IVs and Midlines, and the following central lines: PICCs (Peripherally Inserted Central Catheters), Small Bore Internal Jugular, Femoral or Axillary lines, and Large Bore Quad Lumen lines.  Central lines end in the Superior Vena Cava (SVC) which is just above the heart or the Inferior Vena Cava (IVC) which is just below the heart.

Vascular Access - Central Venous Catheters & Midline Catheter (non-central)

How are vascular access devices used?

Peripheral IVs are used for the short-term administration or infusion of fluid or certain antibiotics that are appropriate for smaller veins.

Midline vascular access device placement

Midlines are used when a patient needs therapy for longer than a few days or the patient has diminished lower arm access insertion sites. Midline catheters can last approximately four weeks and can supply patients with units of blood or certain types of antibiotics.  Midlines can reduce the number of patient sticks as a substitute for multiple PIVs that don’t last the course of treatment.

PICC placement

PICC lines are central lines that end in a large vein near the heart and can stay in a patient for up to 18 months. Patients who need vesicant (more acidic) therapy administration (certain antibiotics, TPN nutrition administration, or hemodynamic agents) for a longer period will generally receive a PICC line provided it is clinically appropriate. Since peripherally inserted, PICCs are generally a less expensive and benign central line option.

Small Bore Internal Jugular (IJ) and Femoral central lines provide vascular access benefits to patients with limited access to the chest or arm area. They are commonly placed in patients who have or likely to have Chronic Kidney Disease (e.g., dialysis patients), Upper Extremity DVTs (deep vein thrombosis), or Bilateral Mastectomy with lymph nodes removed, or who are DIVA’s (difficult IV access patients).  Small Bore central lines preserve upper arm veins should they be needed for other therapies in the future.

Dialysis catheter placement by Vascular Wellness

Large Bore lines, including Quad Lumens, are some of the largest diameter lines allowing for the most flow and can be used as Temporary Dialysis Catheters or Vas Caths. As Vas Caths, they enable dialysis therapy without having to have a fistula or graft placed.

Vascular Access Patient Education | Preparation

How do I prepare for my vascular access procedure?

The preparation is fairly straight-forward.  The vascular access clinician will review the doctor orders and your medical history to confirm the vascular access device, and then obtain your written consent for medical treatment.  The vascular access clinician will ensure a sterile environment, a comfortable position for both you and to obtain access to the insertion site, and the procedure will be done before you know it, generally about ten to sixty minutes long

How is the vascular access procedure performed?

After obtaining consent and confirming the doctor’s orders, the vascular access clinician will use their ultrasound to locate a viable vein.  Once located, the clinician will create a sterile environment, including vapor barrier, mask, gown, and gloves, scrub the area, apply a local anesthetic or numbing agent, and access the vein with a needle.  Using the needle, the clinician will thread a guidewire to hold the access and then remove the needle.  After the needle is removed, an introducer will be threaded over the guidewire.  The catheter will then be placed using the introducer applicable to the technique.  The line will be flushed, cleaned, and dressed, and the location confirmed via ECG or X-ray.

Vascular Access Patient Education | Risks

What are some risks with vascular access procedures?

Why is Infection Control Important

Risk of Infection – This is mitigated by maintaining sterility during the procedure and following best practices for care and maintenance.

Ultrasound-Guided Arterial Line Placement

Risk of Bleeding – This is mitigated through expert usage of the ultrasound to enable accurate vein and needle tip visualization.

Ultrasound placement of a vascular access device

Risk of DVT– This is mitigated through expert usage of the ultrasound to help ensure that the catheter to vein ratio allows for optimal blood flow around the catheter.

Vascular Access Patient Education | Device Care

How do I care for my catheter or line?

Your PICC line or Midline catheter does need care and attention to keep it clean and working.  This care includes changing the bandage (dressing), flushing the catheter with fluids, and changing the cap on the end of the catheter.  You must always wash your hands with soap and clean running water before and after touching any part of your catheter.  You must comply with all follow-up care instructions by your healthcare provider.  Sterile techniques must be used for dressing change, and if you or your family member, friend or anyone assisting you does not know sterile dressing techniques, you must contact your healthcare provider for instructions.  Dressing changes are as directed, which are usually about once per week; however, you must check the dressing daily and change it sooner if the dressing gets dislodged, wet, or soiled.  The catheter will be removed when it is no longer needed or indicated for use, if complications occur, or if it becomes infected.  In addition, you should avoid lifting anything heavier than 15 pounds and repetitive movements as that may dislodge the catheter. 

Vascular Access Patient Information

Midline Patients

What is a Midline?

A midline is a flexible catheter (shorter than a PICC) that is inserted into the vein in the upper arm and the tip ends before the armpit. 

Why is a Midline used?

Midline is used to administer medication that is non-irritating to the vein, and provides greater flexibility than an IV. Midlines can be used for either short or longer intervals on patient with difficult vein access.

midline vascular access placement

How do you care for a Midline?

  • Keep the dressing clean and dry and always wash your hands before handling.

  • Report loose dressings. Ask for loose dressings to be checked and changed if they are no longer sticky or become wet. 

  • No submersion in water.  No hot tubs, swimming, or tub baths.

  • Cover while showering with plastic wrap. Cling wrap works best, and be sure to make a seal! If you are in the hospital, ask your nurse for a PICC line shower covering before you shower. Use handheld shower, if possible, to direct water away from your line. 

  • NO compression sleeves like an ACE wrap or Coban.  

  • Keep line clamped when not in use. 

  • No sharp objects such as scissors around your dressing.

  • No heavy lifting, including heavier than 10-15 pounds. 

  • Do not use crutches on the same side of your Midline. 

  • When taking blood pressure, use the arm without the Midline. 

What are possible Midline concerns?

Call your provider for any of these signs:

  • redness
  • pain
  • drainage
  • swelling around the dressing or in the affected arm
  • fever over 101 degrees
  • leaking of fluid when flushing the catheter

PICC Patients

What is a PICC line?

PICC stands for “Peripherally Inserted Central Catheter”. It is a flexible catheter inserted into the vein in the upper arm and its tip positioned just above the heart. 

Why is a PICC line used?

A PICC line is used to administer medicine for an extended interval, and for treatments that are irritating to the veins of the hands and forearm when using a short catheter. It can also be used for shorter intervals for patients with difficult vein access. Typical usage for extended use includes long-term antibiotics. 

PICC Line

How do you care for a PICC line?

  • Keep the dressing clean and dry and always wash your hands before handling.

  • Report loose dressings. Ask for loose dressings to be checked and changed if they are no longer sticky or become wet. 

  • No submersion in water.  No hot tubs, swimming, or tub baths.

  • Cover while showering with plastic wrap. Cling wrap works best, and be sure to make a seal! If you are in the hospital, ask your nurse for a PICC line shower covering before you shower. Use handheld shower, if possible, to direct water away from your line. 

  • NO compression sleeves like an ACE wrap or Coban. 

  • Keep line clamped when not in use. 

  • No sharp objects such as scissors around your dressing.

  • No heavy lifting, including heavier than 10-15 pounds. 

  • Do not use crutches on the same side of your PICC line. 

  • When taking blood pressure, use the arm without the PICC line. 

What are possible PICC Line concerns?

Call your provider for any of these signs:

  • redness
  • pain
  • drainage
  • swelling around the dressing or in the affected arm
  • fever over 101 degrees
  • leaking of fluid when flushing the catheter

Internal Jugular (IJ) Patients

What is an Internal Jugular Central Venous Line?

An Internal Jugular (IJ) Central Venous Catheter (CVC) is a flexible catheter that is inserted into the vein in the neck, with its tip positioned just above the heart. 

Why is an Internal Jugular Central Venous Line used?

An IJ CVC is used administer medications for short-term or long-term interval when a PICC or Midline is not possible or when there are restrictions to placing the catheter in the upper arm.

Small Bore Internal Jugular Central Venous Catheter Lines

How do you care for an IJ CVC Line?

  • Keep the dressing clean and dry and always wash your hands before handling.

  • Report loose dressings. Ask for loose dressings to be checked and changed if they are no longer sticky or become wet. 

  • No submersion in water.  No hot tubs, swimming, or tub baths.

  • Avoid the site on the neck from getting wet when showering.  

  • Keep line clamped when not in use. 

  • No sharp objects such as scissors around your dressing.

  • No heavy lifting, including heavier than 10-15 pounds.

 What are possible IJ CVC Line concerns?

Call your provider for any of these signs:

  • redness
  • pain
  • drainage
  • swelling around the dressing in the neck or the arm of the same side

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Vascular Wellnesssm 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, Skilled Nursing Facilities, Surgical and Outpatient Centers, Hospice, and At-Home care. We support a 98+% Success Rate with zero (0) Insertion-Related Infections 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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