Can U Explain the difference? pleeease??

[TraumaGirl1018]

ok i still have trouble telling the difference between a PICC line and a midline catheter...they're not the same thing, correct? Can someone explain the difference in terms I'll understand? From what I thought, is it that the PICC tip lies in the SVC while a midline lies in the subclavian? Or am I totally off? My Fundamentals book has a poor explaination...oh, and one more thing, what is a Cordis?

Thanks for anyone who helps!

[jojotoo, RN]

So, is a Quinton cath only venous access? Or is like a regular AV shunt that's used for HD?

[CritterLover, BSN, RN]

so, is a quinton cath only venous access? or is like a regular av shunt that's used for hd?

hmmm....i'm not really sure what you are asking.

here is the part of the national kidney foundation's website that deals with dialysis access, it explains the options well (much better than i could).

http://www.kidney.org/atoz/atozitem.cfm?id=166

quinton is a brand of dialysis catheter. i'm used to referring to them as either a "vas cath" (short term access) or a "permcath" (long term access).

from what i've seen, they can also be used for pheresis, which i know next to nothing about, other than it is similar to dialysis (in that it filters blood) and requires high flow rates.

preferred site (according to the national kidney foundation) is the right internal jugular vein, but they can be placed in either jugular vein, either subclavian vein, or either femoral vein.

[CRNI-ICU20]

To Anne: Quinton caths are used for dialysis....and we have been taught to be very careful with these, as there is a high incidence of line infection this these....and if you think about it....THIS IS THE PATIENT'S ONLY MECHANISM FOR KIDNEY FUNCTION....albeit via dialysis...ie, the catheter is the patient's way of having kidney function....so, you don't want them pulled out...or kinked, or clogged....etc.

In some instances, we have used them for emergent IV access when there was no other place to access....but this was when a patient was in need of fluids, or hypotensive, etc...

Some dialysis caths come with a little piggytail that can be used for IV fluid administration, even when being dialyzed...a nice feature...and blood draws can be obtained here as well....

The lumens are typically heparinized.

Hope this helps you understand...

[crissrn27, RN]

In the short time I did dialysis, we used 5000-10000 u of heparin to maintain the perm-cath, so you wouldn't want to flush that back into the pt. Also saw several did when their perm-caths where lost due to infections, so I always (at the hospital) left them alone. Not worth it, except in extreme situations. Great responces, I learned alot!

[anne74]

Thanks for the dialysis cath info - very helpful!

So, if in the rare occasion we're required to use it for venous access, how much do you draw back to ensure you're withdrawing all the heparin out? 5 or 10cc's?

[crissrn27, RN]

It depends on the type of cath. Some are 3cc draw-back, some 5cc, etc. If they pt can afford it, I would do the 5cc draw-back everytime, prevents flushing the heparin back into the pt. Actually, there might be some with higher cc of heparin in the ports, maybe some of the great minds here will know, you guys rock

[CritterLover, BSN, RN]

thanks for the dialysis cath info - very helpful!

so, if in the rare occasion we're required to use it for venous access, how much do you draw back to ensure you're withdrawing all the heparin out? 5 or 10cc's?

your facility should have a policy on this if you are ever allowed to use the hd cath (some facilities won't allow it even with an md order).

usually, i think they want you to aspirate 2x the volume of the lumen. the lumen volume is printed on each catheter port. i think it tends to run around 1.2-1.5cc.

i'll look it up in the ins book (intravenous nurses society) when i'm at my desk again and make sure that is what they recomend.

now, this is when using the catheter for iv med administration; i think if you are going to use it for blood samples, you'd need to draw a bigger waste.

[southern_rn_brat]

great thread!!