UKOMNAS PDVF flashcards
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32 cards. Read the term and the definition here. The deck at the top of this page is optional.
- Vascular access device
- Any catheter or cannula placed into a vein or artery to deliver therapy, obtain blood samples, or monitor haemodynamics; includes peripheral cannulas, midlines, PICCs, CICCs, ports, and tunnelled catheters.
- PDVF practitioner scope
- The defined set of insertion, maintenance, and complication-management activities a practitioner is trained, assessed, and authorised to perform under local policy and professional regulation.
- Insertion bundle
- A set of evidence-based practices applied together at insertion - hand hygiene, maximal barrier precautions, skin antisepsis, optimal site selection, and daily review - to reduce catheter-related bloodstream infection.
- Vesicant drug
- A substance that causes tissue necrosis or severe injury if it extravasates; examples include anthracyclines and vinca alkaloids, and central access with confirmed tip position is required before infusion.
- Cephalic vein
- A superficial vein running along the lateral aspect of the upper limb that drains into the axillary vein; it is often selected for PICC insertion because of its relatively straight course.
- Basilic vein
- A superficial vein on the medial upper limb that joins the brachial veins to form the axillary vein; it is large but lies close to the brachial artery and median nerve.
- Cavoatrial junction
- The point where the superior vena cava meets the right atrium, approximately 2–3 cm below the carina on chest radiograph; it is the ideal landmark for a central catheter tip.
- Venous compressibility
- The degree to which a vein collapses under light ultrasound probe pressure; a fully compressible anechoic lumen indicates a patent vein, while non-compressibility suggests thrombosis.
- Informed consent elements
- The nature of the procedure, its benefits and risks (infection, thrombosis, bleeding, malposition), alternatives, and the patient's right to withdraw, documented before the procedure.
- Coagulation threshold
- Locally defined laboratory limits (commonly INR ≤1.5 and platelets ≥50 ×10⁹/L) used to guide whether central catheter insertion can proceed safely, with individual risk assessment.
- Contraindication to PICC
- A condition that precludes PICC insertion, such as active site infection, target vein thrombosis, ipsilateral lymphoedema after mastectomy, or an arteriovenous fistula in the same arm.
- Maximal sterile barrier
- The combination of sterile gown, sterile gloves, cap, mask, and full-body sterile drape used during central venous catheter insertion to minimise contamination of the insertion site.
- Chlorhexidine skin antisepsis
- Application of 2% chlorhexidine in 70% alcohol to the insertion site, allowed to dry completely before puncture, as the preferred skin antiseptic for central venous access.
- Aseptic non-touch technique
- A framework that identifies key parts of equipment that must remain sterile and protects them from contamination during procedures, while non-key parts may be touched.
- Hub disinfection
- Scrubbing the access port with 70% alcohol or chlorhexidine for at least 15 seconds and allowing it to dry before accessing the catheter, to reduce intraluminal contamination.
- Peripheral cannula gauge
- The diameter size of a peripheral cannula (14G–24G); smaller gauge numbers indicate larger diameter and higher flow, and the smallest gauge meeting therapy needs should be selected.
- Poiseuille flow relationship
- Flow through a tube is proportional to the fourth power of its radius and inversely proportional to length and fluid viscosity, explaining why larger-gauge cannulas deliver markedly higher flow.
- Ultrasound short-axis view
- A transverse view of a vessel showing a circular cross-section; compressibility and pulsatility help distinguish veins from arteries, and the needle tip appears as a bright point.
- VIP phlebitis score
- A five-point visual infusion phlebitis scale grading erythema, pain, induration, palpable cord, and purulent discharge, used to decide whether a peripheral cannula should be removed.
- PICC tip confirmation
- Verification of central catheter tip position using intracavitary ECG (P-wave change at the cavoatrial junction) and/or chest radiograph before the device is used for infusion.
- Seldinger technique
- A catheter insertion method using needle puncture, guidewire placement, dilation, catheter advancement over the wire, wire removal, and confirmation of blood flow and tip position.
- Power-injectable PICC
- A central catheter rated for contrast injection at a specified maximum flow rate; non-power-injectable catheters must never be used for power injection because of rupture risk.
- CICC insertion sites
- The internal jugular, subclavian, and femoral veins; the internal jugular is often preferred because of lower pneumothorax risk compared with the subclavian approach.
- Air embolism management
- Place the patient in left lateral Trendelenburg position, administer 100% oxygen, and obtain urgent medical review when sudden dyspnoea, chest pain, and hypotension occur during catheter manipulation.
- Arterial puncture response
- Withdraw the needle, apply firm pressure for at least 5–10 minutes (longer if anticoagulated), monitor for haematoma, and escalate if bleeding continues or distal perfusion is compromised.
- Extravasation management
- Stop the infusion, aspirate residual drug if possible, remove the cannula, elevate the limb, apply cold or warm compress per drug protocol, and document the event and patient response.
- Catheter-related thrombosis
- Formation of thrombus around or within a central catheter, presenting with unilateral swelling, pain, and collateral veins; confirmed by duplex ultrasound and managed with anticoagulation and possible removal.
- Pulsatile flush technique
- A push-pause flush using a 10 mL or larger syringe that creates turbulence to clear the catheter lumen, followed by positive pressure to prevent blood reflux.
- Syringe size rule
- Never use a syringe smaller than 10 mL on a central catheter, because small syringes generate high pressure that can rupture the catheter or dislodge a thrombus.
- Dressing change interval
- Sterile transparent semi-permeable dressings are changed every 7 days, gauze dressings every 2 days, and any dressing immediately if it is damp, loose, or soiled.
- CRBSI rate calculation
- The number of catheter-related bloodstream infections divided by total catheter-days, multiplied by 1000, expressed as infections per 1000 catheter-days for benchmarking.
- Insertion documentation
- The record of date and time, operator, device type and gauge, site, number of attempts, ultrasound use, tip confirmation method and result, and patient tolerance.