Advanced IV Access Existing Central Lines are very easy to access. Arizona Paramedics may access these with proper training and with proper Base Medical Control. Different types of Existing Central Lines 1. Hickman, Broviac, 2. Groshong 3. Port-A-Cath 4. PICC Remember that these are CENTRAL LINES and must be treated with very ASEPTIC Technique. Used for: Chemotherapy, Blood, TPA, Heparin, Other medications Advantages: Medication delivered into large vessel Medication does not damage vessels Patient does not need repeated IV access needle sticks Disadvantages: Requires surgical insertion Pneumothorax at time of insertion Bleeding at site Hematoma at site Infection Site needs continual care and dressings Port and tubing outside on chest/neck Thrombosis formation Potential Problems Hematoma/Bleeding at site Apply direct pressure Infusion slow/sluggish Check for kinked tubing Reposition patient Raise arm on same side as catheter Roll patient to opposite side Have patient sit up Have patient take deep breath or cough (Be creative) Try whatever comes to mind!!! Potential Problems Infiltration/Extravasation Clamp tubing Air embolism (respiratory distress) Clamp catheter immediately and turn patient on left side with head down so air enters the right atrium and pulmonary artery. Maintain this position for 20-30 minutes. PORT-A-CATH REQUIRES A SPECIAL NEEDLE FOR ACCESSING called a (HUBER NEEDLE)-Non Coring Needle 1 2. 3. 4. 5. 6. 7. 8. 9. 10. Wash hands thoroughly. Put on gloves Aseptic technique is to be used Gather Supplies (Huber needle, syringe, IV Solution) Open Huber Needle, flush it with NS to purge air. Locate the portal septum by palpation, cleanse skin with betadine then alcohol. Inform patient that you will be inserting needle. Insert needle. Release the clamp on needle tubing and flush with 1cc NS Withdraw 8-10cc of blood, clamp tubing, remove syringe and discard blood. Unclamp tubing and run IV Solution at desired rate. Place a sterile 2X2 gauze pad underneath the hub of the needle. Place transparent dressing over the needle. Huber Needle Any Questions ?