A question for an IV Nurse

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timon,

was that the wart hog or the other one?

A central catheter is non-tunneled or percutaneous, has up to 4 lumens and has a dwell time of usually less than a month. It can be placed in the femoral, jugular or subclavian veins.

A Groshong is one of several types of tunneled lines, there is also a Hickman and Broviac. It is placed into a central vein, usually the subclavian and then the superior vena cava and subcutaneously tunneled to an exit site about 10cm from the insertion site.

It will also have a Dacron cuff about 2-3cm from the exit site to provide a barrier against microrganisms.

Any time a central line of any type is placed in the subcalvian or superior vena cava an x-ray must be done to confirm placement.

Any other information should be readily available at any number of web sites, right now I am to tired to look one up for you.

And don't forget PICC lines, central implanted devices (MediPort), PAS Port, and Midline catheters. Almost forgot, there is also the Quinton cath. eek.gif

HAFND

------------------

Haji

We live in an age that if you order a pizza delivered to your house and call 911 at the same time to report a life or death situation....my money is on the pizza arriving first! Learn to protect yourself, become a wolf among the sheep!

[This message has been edited by haji (edited March 21, 2001).]

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Timon is a merecat indigenous to the African plains. Pumba is the wart hog. When the movie first came out my son and his girlfriend were Timon and Pumba right to the T. He had license plate IMTIMON ( someone got timon first) and she had Pumba. TTFN

P.S. Don't forget tessio's used for dialysis..

[This message has been edited by 3651bht (edited March 21, 2001).]

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Timon is a merecat indigenous to the African plains. Pumba is the wart hog. When the movie first came out my son and his girlfriend were Timon and Pumba right to the T. He had license plate IMTIMON ( someone got timon first) and she had Pumba. TTFN

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I was wondering what anyone could tell me about the tessio dialysis cath. Is this a needleless system. I am just curious, and any help would be greatly appreciated.

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What is the difference b/t a Groshong catheter and a regular Central line and why can a Groshong stay in so much longer than a CL? Thanks and pardon my ignorance--

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Haji, thanks so much for your info. Timon rules!

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Bettie,

Tessio's are separate catheters that are tunneled into the internal jugular. Each one has a colored clamp that should be kept closed when not in use. We used luer lock caps on the ends between treatments. Yes, the dialysis nurse can use a needle less adapter on the vacutainer to draw blood. We draw coags after dialysis when there is very little heparin left in the system. I hope someday the tubing on dialysis systems is needle less. Maybe some units already have it. We still must use needles to give EPO and calcigex, and iron.... Tessio's are used for long-term dialysis when a patient's vascular system won't support any other access. We don't have too much trouble with them. They are flushed post treatment with 5000:1 heparin. The dosage is written on each lumen i.e. 1.5 cc 1.9 cc etc. Hope this helps...TTFN P.S. I must correct myself. The correct spelling is merekat....

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Bettie,

Tessio's are separate catheters that are tunneled into the internal jugular. Each one has a colored clamp that should be kept closed when not in use. We used luer lock caps on the ends between treatments. Yes, the dialysis nurse can use a needle less adapter on the vacutainer to draw blood. We draw coags after dialysis when there is very little heparin left in the system. I hope someday the tubing on dialysis systems is needle less. Maybe some units already have it. We still must use needles to give EPO and calcigex, and iron.... Tessio's are used for long-term dialysis when a patient's vascular system won't support any other access. We don't have too much trouble with them. They are flushed post treatment with 5000:1 heparin. The dosage is written on each lumen i.e. 1.5 cc 1.9 cc etc. Hope this helps...TTFN P.S. I must correct myself. The correct spelling is merekat....

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Originally posted by timonrn:

What is the difference b/t a Groshong catheter and a regular Central line and why can a Groshong stay in so much longer than a CL? Thanks and pardon my ignorance--

A Groshong cath dose not use heparin because it has a flap on the end to prevent blood form backing out. When not in use can be flushed weekly with normal saline.

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Originally posted by timonrn:

What is the difference b/t a Groshong catheter and a regular Central line and why can a Groshong stay in so much longer than a CL? Thanks and pardon my ignorance--

The difference between a Groshong Central catheter and a standard central catheter is the Groshong Valve. This valve is incorporated on all of the Groshong catheters. The tip of the catheter is rounded and closed. When the catheter is not in use, the valve stays closed preventing the back flow of blood and air into the catheter. Negative pressure causes the valve to open inward allowing for blood withdrawal. When positive pressure enters the catheter either by gravity syringe or IV pump the valve opens outward allowing for the fluid to infuse. Because of the valve the company promotes the fact that anticoagulant flushes are not necessary. However, we maintain our heparin flush protocols and use only saline flushes on selected patients.

As far as dwell time goes just because a catheter has a Groshong valve does not allow for a longer dwell time. There are other factors that effect dwell time such as the type of material the catheter is made of such as silicon vs polyurethane. Also the type of central line will also effect the dwell times. For instance a Triple lumen Catheter is a central line designed for acute care vs a peripherally inserted central catheter (PICC) which is also a central line which has a longer dwell time. You then have the subcutaneous chest and arm ports that are implanted central lines and don't forget the tunneled devices such as the Hickman catheter. The type of catheter that is chosen should fit the patient's needs but remember all central line placements have the tip of the catheter located in the Superior Vena Cava ( SVC). Ideally the tip locations should be at the distal SVC atrial junction.

[This message has been edited by Lauretta (edited March 30, 2001).]

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I am curious about what size syringe everyone uses to flush central lines. I was taught to use nothing smaller than a 10cc syringe, but the facility where I do clinical uses prefilled 3cc syringes to flush with Heparin and routinely uses prefilled 3cc syringes of saline as well. Any advice?

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