Pediatric Vascular Access Devices
Pediatric Vascular Access Devices
Infusion ports and catheters are essential vascular access devices used in pediatric care for medication administration, fluid therapy, blood sampling, and long-term treatment management.
Key Features
- Multiple access options
- Various duration of use capabilities
- Different insertion techniques
- Size-specific options for pediatric patients
- Biocompatible materials
General Considerations
- Patient size and age
- Expected duration of therapy
- Type of medications/solutions
- Frequency of access needed
- Risk factors and contraindications
Types of Vascular Access Devices
Peripheral Intravenous Catheters (PIVCs)
- Characteristics:
- Short-term use (3-5 days)
- Sizes: 24G-20G for pediatrics
- Single lumen design
- Flexible cannula material
- Common Sites:
- Dorsum of hand
- Forearm
- Antecubital fossa
- Foot (infants)
Central Venous Catheters (CVCs)
- Non-Tunneled CVCs:
- Short to medium-term use
- Multiple lumens available
- Emergency access capability
- Various French sizes
- Tunneled CVCs:
- Long-term use
- Dacron cuff for anchoring
- Lower infection risk
- Brand options (Broviac, Hickman)
Implantable Ports
- Features:
- Totally implanted device
- Long-term access (years)
- Reduced infection risk
- Better cosmetic outcome
- Components:
- Reservoir chamber
- Self-sealing septum
- Connected catheter
- Huber needle access
Insertion Procedures & Management
Pre-Insertion Assessment
- Coagulation status
- Anatomical considerations
- Previous access history
- Consent and preparation
- Device selection criteria
Insertion Techniques
- PIVC Insertion:
- Aseptic technique
- Vein selection
- Stabilization methods
- Securement devices
- CVC Placement:
- Ultrasound guidance
- Modified Seldinger technique
- Tunneling procedure
- Position verification
- Port Implantation:
- Surgical procedure
- Pocket creation
- Catheter tunneling
- Port positioning
Complications & Care Management
Common Complications
- Immediate:
- Bleeding
- Pneumothorax (CVCs)
- Arterial puncture
- Malposition
- Delayed:
- Infection
- Thrombosis
- Catheter migration
- Occlusion
Maintenance Protocols
- Daily Care:
- Site assessment
- Dressing integrity
- Patency checks
- Documentation
- Regular Maintenance:
- Flushing protocols
- Dressing changes
- Cap changes
- Line repairs
Clinical Applications & Best Practices
Indications
- Short-term Access:
- Acute medication administration
- Perioperative management
- Emergency situations
- Diagnostic procedures
- Long-term Access:
- Chemotherapy
- Parenteral nutrition
- Chronic medication needs
- Frequent blood sampling
Special Considerations
- Age-Specific:
- Neonatal considerations
- Infant-specific devices
- Adolescent preferences
- Disease-Specific:
- Oncology protocols
- Chronic conditions
- Critical care needs
Quality Metrics
- Infection rates
- Complication frequency
- Device longevity
- Patient satisfaction
- Cost-effectiveness
