WHat is the difference between these Central lines???

[raindrop]

I don't know what the difference is between a Groshong, portacath, infusaport.......can any please tell me the difference, and what the difference is in appearance. I want to be able to look at a line and determine what type it is.

Also, how do you access a port that has been closed or not used?

[TazziRN, RN]

Indwelling ports (portacath, etc.) cannot be differentiated because they're under under the skin. You have to know which one it is. Accesses are similar in technique, though.

All lines will be flushed periodically, even if not actually in use. To use them, flush with NS, instill your solution, flush with NS again, then heparin.

[Sabby_NC]

From memory a Groshong catheter has a valve system allowing for aspiration, infusion and when not in use the valve is in a neutral position. You do not need to coagulate this line because the closed valve prevents blood from getting into the catheter and cause clotting. Without getting the books out the Superior Vena Cava pressure acts on this catheter allowing infusion to occur when the pressure drops. Cannot remember the mmHg figures.

Portacath's and Infusaports are both inserted under the skin and usual go into a large bore vein such as the Subclavian vein. These devices are single lumen and require the SASH technique every 4-6 weeks to maintain patency. Remember these usually have a 10ml reservoir. These are accessed using a special needle called a huber needle. Oops forgot to say with these though you have to flush normally with 20 MLS post access due to the 10ml reservoir. Especially if you have been doing a lab draw.

You will see PICC, CVC etc you will learn them all in time. Ruddy confusing all these lines if you ask me hahahahahaha

If you cannot push NS in without forcing do not use it because you can rupture the catheter. If you cannot draw blood back do not force it.

If I have a CVC line that has three lumens and one is blocked I mark it clearly so it is not used.

Relax you will get to know them all. :)

[kalaka24]

PICC lines are mostly placed in the upper arm, & can be single or double-lumen ports. Sometimes PICC lines have to be flushed hard because of the length of the catheter. You will be able to tell though if the port is clotted off & not just needing more pressure to flush. You are supposed to flush PICC lines with 10mL of saline & waste 10 mL before drawing your sample. PICC catheter lines are usually white & sutured to the upper extremity. If a port is clotted off, you can flush it with retavase or cath-flo to un-clot it. Where I work, you have to get a doctor's order first to do this; it is not considered an independent nursing action.

CVL can be placed in the internal jugular or subclavian vein. I have seen double & triple lumen only. Flush & waste with these the same way as a PICC line.

And from what I remember about Infusaports, the huber needle can only be used once. If you miss the port, you have to get a new needle since it is a sterile procedure to access it. It's a good idea to find the parameters of the port under the skin & surround it with your thumb & index finger to help "secure" it in place when accessing it with the huber needle. It can sort of "slide" away from you if you don't secure it while trying to access it.

It does get easier over time to recognize which is which & how to access each one. And sometimes you can ask the patient; they typically know which port they have or they have an implant card they carry with them. Families often know too.

[NRSKarenRN, BSN, RN]

Central lines, portacath instruction for patient + device pictures

http://surglinks.com/central.lines.htm