The remaining catheter portion is exposed but provides external access to eliminate needle sticks. A retention suture sometimes is used to hold the catheter until the tissue grows around this cuff, which takes 1 to 4 weeks. It has a cuff that stimulates tissue growth and helps hold the catheter in place the catheter is positioned with the cuff 2 to 4 cm from the insertion site. Tunneled catheterĪ tunneled catheter must be inserted invasively to help secure it and promote longevity. Patients should be assessed daily to determine if they still need the catheter it should be removed as soon as it’s no longer needed. The Centers for Disease Control and Preven-tion (CDC) doesn’t recommend their routine replacement. Indicated for acute short-term conditions, nontunneled catheters come with single, double, triple, or quadruple lumens and in multiple sizes (14 to 22 G). If the patient is chronically ill or other veins are hard to access, the catheter may be placed in another vein, such as the translumbar vein. Nontunneled catheterĪ nontunneled catheter typically is inserted in the neck, chest, or groin using the internal jugular or subclavian vein or, in emergencies, the femoral vein. A catheter that’s too large can cause arm swelling and deep vein thrombosis. Central catheter placement using ultrasound allows measurement of the patient’s vein size, which ensures an appropriate-size catheter to allow blood to flow around it. Once the clinician determines the patient needs a central catheter, the next decision is how many lumens the catheter should have. Each catheter type has risks and benefits, which clinicians must discuss with patients when planning care. The type of catheter used depends on the therapy required (such as total parenteral nutrition, lipids, or multiple antibiotics) and patient characteristics (for instance, the need for a central catheter versus a less invasive peripheral line). Some clinicians prefer a tapered catheter, using the catheter or a dressing technique to stop bleeding at the insertion site. Tapered catheters are wider at the insertion site, in essence plugging the larger-insertion puncture site to lessen bleeding. Catheters also vary in number of lumens (from one to four) and in French size (4 to 14 Fr), with either a straight or reverse taper on the distal portion.
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