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Central Venous Access Device

   

Added on  2020-04-15

11 Pages3078 Words487 Views
Running head: CVAD RELATED COMPLICATIONS CENTRAL VENOUS ACCESS DEVICE RELATED INFECTIONName of the StudentName of the UniversityAuthor note

CVAD RELATED COMPLICATIONS1CVAD or Central Venous Access Device is a system, which is inserted in the veins of thepatient to deliver blood stream to the patient. It is utilized in different medical interventions forthe insertion of fluids, resuscitation or blood different hyper-osmolar drugs to the bloodstream(Moureau et al. 2013). This assignment is going to discuss about Jim Karas (59), who wasadmitted to hospital after being unresponsive and unable to breathe out. He was admitted to theemergency department of the hospital and after his primary health check-up, doctor insertedthree central venous catheter into his right subclavian veins using surgical aseptic non touchtechnique (ANTT). This assignment will be discussing the complications of Jim Karas which isCVAD associated bloodstream infection and the preventive strategy of it, prevention andmanagement of occlusion and local skin irritation because of these medical interventions. Thesecomplications, its types, infection process, prevention and management process will be discussedwith the help of literatures and the critical discussion will be presented below. The moment when Jim was found unresponsive, doctors were able to detect a faintcardiac pulse and therefore they inserted an oropharyngeal airway intravenous cannula andprovided him with 100 percent oxygen ventilation. He was still unresponsive to the treatmentsand therefore the doctor Jaram incubated him for mechanical incubation. Finally, the doctorinserted three central venous catheters (CVC) in the veins of Jim to improve his conditionHowever, one day later, a red swollen infection was found near the insertion site of CVC and theinfection was detected as the Central Line Associated Bloodstream Infection (CLABSI) (Millerand Maragakis 2012). It is a common factor in the long-term use of catheter in the blood stream.There can be several reasons due to which, the CVAD related infection could occur in patients.Few of such reasons are ruptured catheter, dislocation of the catheter inside the vein, chylothoraxand paravasation (Yeoh et al. 2013). In the case study, Jim was also suffering from infection and

CVAD RELATED COMPLICATIONS2his swollen site of catheter injection was indicating towards the fact that he was being affectedwith the CVAD related infection. Preventive measuresThere are several preventive measures for the protection from this infection. The primaryand most effective one is application of 2 percent chlorhexidine based alcohol solution andcontinuous skin care after the injection of the catheters in the blood stream, cleaning the injectionhub or the connector will be helpful in preventing such disorder in the injection site (Departmentof Health and Human Services USA, 2018). The ANTT technique or the aseptic not touchtechnique was used as the preventive measure for Jim, which is effective in preventing thebloodstream related infection after injecting the CVC into his body. The doctors continuouslyused hand washes and sanitizers to prevent the normal micro flora of the hand to be colonized inthe wounds of Jim. Another therapy that can be used in the infection of CVAD is continuousdressing of the site of injection (Department of Health and Human Services USA, 2018). If Jimwas provided with continuous dressing of his CVAD insertion site, dressing around the skintunnel until the wound has healed. Further, after the healing of this site, dressing would be donein the injection port pocket (Hentrich et al. 2014). According to the guidelines from the CDC ofUSA, the dressing should be semi-permeable and it should be replaced every time it becomesdamp or loosened. Two percent chlorhexidine solurton should be used for the cleansing purposeof Jim and this strategy is effective in preventing primary BSIs (Department of Health andHuman Services USA, 2018). These are the ways the nursing staff of the organization should beused to provide care to Jim in his CVAD related infection. These researches are based on thelevel I of the level of evidence and within this, randomized control trial or RCTs and meta-

CVAD RELATED COMPLICATIONS3analysis studies are included. The preventive measured that have been used for Jim aredepending on the CDC department of the United States of America. Therefore, it was used forJim to prevent his CVC related bloodstream infections (Lai et al. 2013). The second complication that Jim suffered during the treatment in the healthcare systemafter his unresponsiveness was occlusion. According to the data, 14 to 36 percent of patientsgenerally suffers from the catheter related occlusion and the time taken for the occurrence of theocclusion is 1 to 2 year after the injection of catheters (Oliveira et al. 2012). The occlusion canbe partial in which, the blood is not been able to aspirate but the catheter infusion is possible(Zhang et al. 2014). However, due to occlusion, neither aspiration nor the infusion is possible(Linnemann 2014). The primary reason for occlusion is the usage of low quality catheters for theintervention (Oliveira et al. 2012). The secondary reason can be the several mechanical issues,emerging after the application of the catheter in the bloodstream (Braithwaite et al. 2014).Finally, there can be reaction between the provided drugs, making the flow of liquid through theveins sluggish. Further, if the pH of the infusion is too alkaline or acidic in nature precipitationcan also be occurred in the blood stream creating an occluded condition. Even high amount oflipid residues in the nutrition can cause the occlusion condition (Zhang et al. 2014). According tothe Bolton (2013), intraluminal clots are one of the reasons due to which, catheter occlusionoccurs and according to the statistics, 5 to 26 percent of the catheter occlusions are resulted fromit. There are several management strategies of occlusion due to catheter or physiologicalproblems. The first strategy is about the mechanical obstruction of catheter (Lam et al. 2012).These can be of different types, such as kink in the catheter tubing, a tight suture, inadvertentlyclosed clamp, blood vessel wall blocking the tip of the catheter.

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