UKOMNAS PDVF key terms

Any catheter or cannula placed into a blood vessel to deliver fluids, medicines, blood products, or to sample blood. Includes short peripheral cannulas, midlines, PICCs, central venous catheters, and implanted ports.

The Indonesian competency standard for inserting and maintaining vascular access devices. It covers assessment, aseptic insertion, ultrasound-guided technique, complication recognition, device care, documentation, and professional accountability for nurses and clinicians.

The legally and professionally defined limits of what a clinician may do, based on training, competence, and local policy. Inserting or removing a device outside this boundary exposes the practitioner to disciplinary and legal consequences.

Choosing which vein to cannulate based on diameter, depth, straightness, valve position, and the planned therapy. Preference usually goes to a straight, well-filled forearm vein that spares the antecubital fossa and the patient's dominant arm.

A large vein on the medial forearm that runs toward the axilla. Its diameter and straight course make it a preferred site for peripherally inserted central catheters, though it lies close to the brachial artery and median nerve.

A superficial vein running along the lateral forearm and upper arm. It is often visible and easy to cannulate peripherally but is less favoured for central catheters because of its narrow caliber and sharp turns near the shoulder.

Flap-like structures inside veins that prevent backflow. They can block a catheter tip during insertion, so the clinician may need to advance through them with gentle flush-and-withdraw technique or choose another vessel.

Using real-time ultrasound imaging to visualize a vein, guide the needle tip into the lumen, and confirm placement. It improves first-attempt success and reduces arterial puncture, especially in patients with difficult or deep veins.

A clinical situation in which a patient's veins are hard to find or cannulate, often due to obesity, dehydration, prior chemotherapy, or repeated punctures. It usually calls for ultrasound guidance and escalation to a more experienced operator.

Placement of a short cannula or midline into a peripheral vein, usually in the forearm or hand, for short-term therapy. It is the most common vascular access procedure but carries risks of phlebitis, infiltration, and infection.

Placement of a catheter whose tip sits in the lower superior vena cava or cavoatrial junction. It allows delivery of irritant or high-osmolarity solutions and is used for long-term therapy, vasopressors, or hemodynamic monitoring.

A long, thin catheter inserted through a peripheral arm vein, such as the basilic or cephalic, with its tip advanced to the cavoatrial junction. It provides central access for prolonged antibiotics, chemotherapy, or total parenteral nutrition.

The location of a central catheter's distal end, ideally in the lower superior vena cava or at the cavoatrial junction. Too shallow a tip risks thrombosis and malfunction; too deep a tip risks arrhythmia and cardiac injury.

A catheter tip that ends somewhere other than the intended location, such as the internal jugular vein, subclavian vein, or right atrium. It is detected by imaging or pressure tracing and usually requires repositioning before use.

A standardized framework for aseptic practice that separates key parts and key sites from contamination. It defines sterile versus clean technique and guides hand hygiene, glove use, and field preparation during device insertion and care.

Any component of the procedure that, if contaminated, would directly contact the patient's bloodstream or a sterile body area. Examples include the needle hub, catheter tip, and the inside of a sterile connector.

The patient's skin or device access point that must remain aseptic during a procedure. It includes the puncture site, the catheter hub, and any port or connector accessed during care.

Applying chlorhexidine gluconate in alcohol to the insertion site and letting it dry completely before puncture. It is preferred over povidone-iodine because it reduces catheter-related bloodstream infection and remains active on the skin.

A full-body sterile drape, cap, mask, sterile gown, and sterile gloves used during central line insertion. It reduces contamination of the catheter and is standard practice for central venous and PICC placement.

A patient's voluntary agreement to a procedure after receiving understandable information about its purpose, benefits, risks, alternatives, and the right to refuse. It must be documented and obtained before insertion, not after.

Confirming the patient's identity using at least two identifiers, such as name and date of birth, before any procedure or medication. It prevents wrong-patient errors in insertion, blood sampling, and transfusion.

A brief pause before the procedure begins in which the team confirms patient identity, procedure, site, consent, and availability of equipment. It is a core safety step that catches errors before the needle enters the skin.

Reviewing platelet count and clotting tests such as INR or aPTT before an invasive vascular procedure. Abnormal results may warrant correction or a different approach, though minor peripheral cannulation rarely requires routine testing.

Inflammation of a vein, often presenting as pain, redness, warmth, or a palpable cord along the cannulated vessel. It can be mechanical, chemical, or infective and usually requires removal of the device.

Leakage of infused fluid or medicine into surrounding tissue rather than the vein, causing swelling, pain, and coolness at the site. It requires stopping the infusion, removing the device, and assessing for tissue injury.

Escape of a vesicant or irritant drug, such as certain chemotherapy agents, into surrounding tissue. It can cause severe tissue damage and needs immediate cessation of infusion, device removal, and antidote or supportive management per protocol.

A visual infusion phlebitis scoring tool that grades the insertion site for pain, redness, swelling, and palpable cord. Regular scoring helps detect phlebitis early and guides timely device removal.

A bloodstream infection attributed to an intravascular catheter, confirmed when the same organism grows from blood cultures drawn from the device and from a peripheral sample. Prevention relies on asepsis, hub disinfection, and prompt removal of unnecessary devices.

Cleaning the access port with an alcohol or chlorhexidine wipe and allowing it to dry before attaching a syringe or giving set. This simple step reduces contamination of the catheter lumen and bloodstream infection.

Accidental entry of the needle into an artery instead of a vein, recognized by pulsatile backflow and bright red blood. It requires needle removal and firm pressure to prevent hematoma or pseudoaneurysm.

A collection of blood outside a vessel, appearing as swelling, bruising, or pain at the puncture site. It is more likely with arterial puncture, coagulopathy, or inadequate post-removal pressure.

Entry of air into the venous circulation through an open catheter hub or disconnected line, which can obstruct pulmonary blood flow and cause sudden dyspnea, chest pain, or collapse. Prevention includes clamping and positioning the patient appropriately.

The immediate response to a vascular access crisis such as air embolism, severe bleeding, or anaphylaxis. It includes stopping the procedure, calling for help, positioning, oxygen, and following the local emergency algorithm.

Movement of a catheter tip from its original position, often due to coughing, vomiting, or arm movement. It can cause malfunction, phlebitis, or arrhythmia and is assessed by measuring the external catheter length.

The planned or urgent withdrawal of a vascular access device, with inspection of the catheter tip, pressure at the site, and documentation. Indications include completion of therapy, phlebitis, infection, or infiltration.

A contemporaneous record of the procedure, device type and size, site, attempts, complications, patient education, and ongoing assessment. It supports continuity of care and provides legal evidence of competent practice.

A defined route for seeking senior help when insertion fails, complications arise, or the patient's needs exceed the clinician's competence. Knowing when and how to escalate is a core safety behaviour.