VA-BC QUESTIONS AND ANSWERS
When considering vascular access in the pediatric patient what are 9 things to consider
- Answers- 1.age 2. Size 3. Sites 4. Reason for therapy 5. Duration of therapy 6.
Activity and mobility 7. Cognitive abilities 8.)gross and fine motor 9 body image
French scale - Answers- Measurements of the outside of the catheter the larger the
French the larger the catheter
Cvc cath sizes - Answers- Range from 1.2fr neonates to 15fr dialysis cath
Gauge - Answers- Internal diameter of catheter. Iv caths Range from 27g to 12 g
Radiopaque - Answers- All devices manufactured in the USA are required to be. To
visualize tip
Catheter material - Answers- 1.)Silicone-softer more flexible higher in and outer
diameter ratio
2.)Polyurethane-higher tensile strength but some can be degradeded by alcohol
peripheral catheters - Answers- Use for non irritant non vesicant infusions lasting less
than 6 days
6 PIV contraindications - Answers- 1.)Expect infusion more then 6 days
2.)osmolarity>900
3.)vesicant
4.)arm c trauma infection or other problems
5.)not in arm same side as mastectomy c lymph node dissection
6.)fistula
Alternate sites for placing a Iv in an infant/toddler - Answers- <18 months the scalp.
Lower extremities before walking and crawling if possible
What are Indications for a midline Catheter - Answers- 1.) infusions >6 days.
2.)non irritating non vesicant medications
3.) Vancouver can be administered up to 6 days
What are 6 PICC specific considerations - Answers- 1.) don't place in a compromised
arm (trauma infection ect.)
2.)don't place on side affected by CVS there is increased risk of clotting 2nd to decrease
in circulation.
3.)lymph node dissection
4.) no implanted devices
5.) chronic kidney patients
6.) prior catheter related dvts
, where is optimal placement for central lines - Answers- 1.)lower 3rd of the svc or caj
2.)from the fem inferior vena cava above the level of the diaphragm
3.) in pediatrics tip for fem insertion should be between levels T9 and 11
In pediatric population what's the vein of choice for central lines - Answers- Jugular to
avoid pneumo
What are indications to tunnel CVCs - Answers- 1.) infusions months to years
2.)Hemodialysis/aphersis
3.)TPN
4.)chemo/ irritants
5.)difficult Iv access pts.
6.)blood and components
Tunneled CVADS used more frequently in infants and pedi
Contraindications of a tunneled cvc - Answers- 1.)blood stream infection
2.) severe coagulopathy
3.)infection at intended site
Tunneled cvc with cuffs - Answers- Cuff develops tissue attachment and heals in 2 to 3
weeks. Once healed can be maintained without a dressing
What is a power injectable port or catheter - Answers- They are made of polyurethane
and can withstand >300 psi
Emergencies are the only indicators for IO use. What are some contradictions. -
Answers- 1.)Trauma or fax at site
2.)bone disease
3.) infection at site
4.)can't ID landmarks
5.) insertion or attempted insertion with in 48 hours.
6.) previous significant orthopedic procedure at site
IO insertion considerations - Answers- 1.) Maximum dwell time of 24 hours in the US
2.) only 1 attempt in same bone per 48 hours
3.) due to pain admin 2% lido preservative free and epi free as needed
4.)fluid,blood , and meds can be given
5.)apply NS as a running Iv with a pressure bag
Subcutaneous infusion devices - Answers- Med in extracellular matrix to reach
capillaries and lymphatics for absorption into vascular system access device is placed in
fatty tissue below skin at 90 degree angle or 10 to 45 degree angle if using a 24-27g
SQ devices - Answers- For med admin changed Q 7 days
For hydration administration change Q24-48 hours
When considering vascular access in the pediatric patient what are 9 things to consider
- Answers- 1.age 2. Size 3. Sites 4. Reason for therapy 5. Duration of therapy 6.
Activity and mobility 7. Cognitive abilities 8.)gross and fine motor 9 body image
French scale - Answers- Measurements of the outside of the catheter the larger the
French the larger the catheter
Cvc cath sizes - Answers- Range from 1.2fr neonates to 15fr dialysis cath
Gauge - Answers- Internal diameter of catheter. Iv caths Range from 27g to 12 g
Radiopaque - Answers- All devices manufactured in the USA are required to be. To
visualize tip
Catheter material - Answers- 1.)Silicone-softer more flexible higher in and outer
diameter ratio
2.)Polyurethane-higher tensile strength but some can be degradeded by alcohol
peripheral catheters - Answers- Use for non irritant non vesicant infusions lasting less
than 6 days
6 PIV contraindications - Answers- 1.)Expect infusion more then 6 days
2.)osmolarity>900
3.)vesicant
4.)arm c trauma infection or other problems
5.)not in arm same side as mastectomy c lymph node dissection
6.)fistula
Alternate sites for placing a Iv in an infant/toddler - Answers- <18 months the scalp.
Lower extremities before walking and crawling if possible
What are Indications for a midline Catheter - Answers- 1.) infusions >6 days.
2.)non irritating non vesicant medications
3.) Vancouver can be administered up to 6 days
What are 6 PICC specific considerations - Answers- 1.) don't place in a compromised
arm (trauma infection ect.)
2.)don't place on side affected by CVS there is increased risk of clotting 2nd to decrease
in circulation.
3.)lymph node dissection
4.) no implanted devices
5.) chronic kidney patients
6.) prior catheter related dvts
, where is optimal placement for central lines - Answers- 1.)lower 3rd of the svc or caj
2.)from the fem inferior vena cava above the level of the diaphragm
3.) in pediatrics tip for fem insertion should be between levels T9 and 11
In pediatric population what's the vein of choice for central lines - Answers- Jugular to
avoid pneumo
What are indications to tunnel CVCs - Answers- 1.) infusions months to years
2.)Hemodialysis/aphersis
3.)TPN
4.)chemo/ irritants
5.)difficult Iv access pts.
6.)blood and components
Tunneled CVADS used more frequently in infants and pedi
Contraindications of a tunneled cvc - Answers- 1.)blood stream infection
2.) severe coagulopathy
3.)infection at intended site
Tunneled cvc with cuffs - Answers- Cuff develops tissue attachment and heals in 2 to 3
weeks. Once healed can be maintained without a dressing
What is a power injectable port or catheter - Answers- They are made of polyurethane
and can withstand >300 psi
Emergencies are the only indicators for IO use. What are some contradictions. -
Answers- 1.)Trauma or fax at site
2.)bone disease
3.) infection at site
4.)can't ID landmarks
5.) insertion or attempted insertion with in 48 hours.
6.) previous significant orthopedic procedure at site
IO insertion considerations - Answers- 1.) Maximum dwell time of 24 hours in the US
2.) only 1 attempt in same bone per 48 hours
3.) due to pain admin 2% lido preservative free and epi free as needed
4.)fluid,blood , and meds can be given
5.)apply NS as a running Iv with a pressure bag
Subcutaneous infusion devices - Answers- Med in extracellular matrix to reach
capillaries and lymphatics for absorption into vascular system access device is placed in
fatty tissue below skin at 90 degree angle or 10 to 45 degree angle if using a 24-27g
SQ devices - Answers- For med admin changed Q 7 days
For hydration administration change Q24-48 hours
