Specialized Access as Parenteral Routes
Specialized Access as Parenteral Routes
When it is necessary to administer repeated injections over time, it is prudent to employ specialized devices that provide continued access and reduce pain associated with administration.
A central component in modern medical care, several types of central venous catheters are widely used in institutions and outpatient settings for a variety of parenteral medications such as cancer chemotherapy, long-term antibiotic therapy, and total parenteral nutrition (TPN) solutions.
These central venous catheters can remain in place for varying durations, from a few days to several months, depending on the patient's treatment needs.
To maintain the patency of the catheter lumen when not in use, they require heparinization, which involves flushing the catheter with a heparin solution to prevent clot formation.
The use of indwelling plastic catheters significantly reduces the need for multiple punctures during intravenous (IV) therapy, thus improving the patient's comfort and outcomes.
These catheters are typically composed of materials such as polyvinyl chloride (PVC), Teflon, and polyethylene and should be radiopaque to ensure visibility on radiographs.
Different types of catheters are available based on their design and intended use, including:
Plain Plastic Catheters: Basic design suitable for short-term use.
Catheter Over Needle/Outside Needle: Provides a different method of insertion, often for easier access and removal.
Catheter Inside Needle: Used for specific procedures where precise placement is needed.
The injection ports on Broviac and Hickman central vein catheters are unique in that they are not implanted subdermally.
Instead, they are positioned externally, usually at the abdomen, after the catheter has been tunneled under the abdominal skin and chest to connect to the superior vena cava.
While these devices are designed to facilitate repeated access to the infusion site, they carry risks of morbidity, including catheter fractures, entrance site infections, and catheter-associated sepsis.
In response to complications associated with cannulation, newer models have been developed to offer safer alternatives.
These devices can provide repeated access to various infusion sites, including veins, cavities, arteries, or even the central nervous system.
A specialized Huber point needle is utilized to inject through the skin into the rubber septum of a totally implanted central vein access device, ensuring a secure and effective method for administering medications without frequent needle sticks.