Tuesday, January 24, 2012

Central Venous Access Device (CVAD) In the Emergency Room

Over the past two to three decades we have really grown in the health care industry in the fact that we have developed and advanced the infusion and vascular therapy industry by leaps and bounds with the PICC line, Mid-line, and peripheral intravenous catheters.  However, as nurses we have not kept us with the pace of technology in regards to our education and skills sets.  This may seem harsh yet numbers do not lie and with this in mind it is a simple fix. 

Practice, Practice, Practice.

Still many years later we continue to have one in four medications errors in our hospitals as well as approximately 45 000-164 0001 patients get an infection in their central venous access devices (CVAD). 

Most of the infections in our patients CVADs occur the intensive care units (ICU).
 Who is responsible for these infections and errors? We are as nurses.  Whether you are a new graduate nurse or a nurse with a lot of experience it is still our duty and calling to advocate and protect our patients even if that means from us.  Our patients deserve better and we must be diligent in perfecting our skills to the best of our ability by continuing our training and education, practicing, and ensuring we follow the standards of care.

The Infusion Nurses Society (INS) Standards of Infusion Care states that “infection prevention and surveillance protocols shall be in accordance with organizational policies, procedures, and/or practice guidelines and local, state, and federal rules and regulations.2

 (photo Courtesy of Free Digital Photos.net and Renjith Krishnan)
 The INS continues on the say that health care works should also use personal protective equipment (PPE) during all infusion procedures that may potentially expose the health care worker  to blood and body fluids as well as protect the patient from the same.
In order to help prevent a CVAD infection the health care provider should use “Maximal sterile barrier” protections.  Appropriate hand hygiene is also essential as hand hygiene is the single most effective method in preventing infections.
Nurses in the emergency room (ER) should also understand how to care and provide maintenance for CVAD's as they are becoming more prevalent as well  as more and more hospitals are contemplating using PICC teams including for patients in the ER.  ER nurses are under a lot of stress and work often at a fast pace; however, this is not reason not to follow procedures as best of your ability as possible.
To learn more about CVAD's and care and maintenance as an ER nurse stayed tuned for Central Valley Medical's articles,classes, and webinars on caring for patients in the ER with Peripheral Venous Access Device (PVAD's) and CVAD's.


  1. Center for Disease Control. http://www.cdc.gov/. 2011
  2. Infusion Nurses Society. SOC. http://www.ins1.org/. 2011.
  3. Free Digital Photos.Net. http://freedigitalphotos.net/. 2011
  4. Cath Matters. Catheter Education. http://www.cathmatters.com/. 2011