Central Venous Catheters (CVCs)

Importance and Usage

• Recommended by healthcare team for treatments.
• Useful for:
  • Long-term treatment
  • Various medical procedures
• Reduces risk of damage to smaller veins from chemotherapy.
• Can be used for administering:
  • Medicines
  • Fluids
  • Blood products
  • Chemotherapy

Insertion Procedure

• Conducted as outpatient or inpatient.
• Requires informed consent.
  • Watch video for understanding and expectations.
• Procedure Details:
  • Small, flexible tube inserted into a large central vein.
  • Veins used: Jugular, Subclavian, Femoral.
  • Placement based on medical history, intended use, activity level.
  • Various sizes and lumens available.

Risks and Complications

• Generally low risk, but potential issues include:
  • Pneumothorax (Collapsed Lung):
    • Less than 1% risk.
    • Symptoms: Shortness of breath, cough, chest pain.
    • May need hospital stay and treatment.
  • Artery Puncture:
    • Rare due to ultrasound guidance.
    • Can cause hematoma.
  • Nerve Injury:
    • Reduced risk with ultrasound.
  • Incorrect Vein or Catheter Position:
    • Repositioning and X-ray may be required.
  • Other rare issues: Infection, swelling, damage.

Alternatives to CVC

• Medicines through IV in arm.
• Oral or injectable medications.
• Opting out of medication.

Pre-Procedure

• Conduct interview and assessments (medical history, lab work, imaging).
• Anesthesia consultation if needed.
• Consent required after review of procedure.

During the Procedure

• Positioning adjusted for insertion.
• Skin cleaned and covered.
• Local anesthetic administered.
• Ultrasound guides needle into vein.
• CVC inserted using a wire and dilator.
• Sterile dressing applied.
• Post-procedural X-ray for position confirmation.

Post-Procedure Care

• Do not leave Houston area for 24 hours after insertion.
• Await X-ray results before using CVC.
• Weekly maintenance required (sterile dressings, cap changes, flushes).
• Attend CVC care class if leaving Houston.

Conclusion

• Understanding of CVC benefits, risks, and care is crucial.
• Contact care team with any questions or issues.