Fundamentals of Vascular Access and the PDVF Role
Domain 1: Fundamentals of Vascular Access and the PDVF Role
This domain tests how you match a vascular access device to the patient’s therapy, duration, vein condition, and risk profile, and how the PDVF clinician works within a defined scope.
Core rules
- Vascular access is a continuum: peripheral short catheter, midline, PICC, nontunnelled or tunnelled CVC, and implantable port. Choose the least invasive device that reliably delivers the prescribed therapy for its expected duration.
- Device choice depends on solution characteristics: osmolarity, pH, vesicant potential, infusion rate, sampling needs, and whether therapy is continuous or intermittent.
- The PDVF role typically includes focused assessment, ultrasound mapping, difficult-IV rescue, insertion within competency, complication recognition, patient education, and escalation. It does not replace anaesthetic, surgical, or radiological expertise when those are required.
- Preserve veins: start distal, avoid unnecessary central access, and document failed attempts so the next clinician is not guessing.
Worked example
A patient needs five days of IV flucloxacillin. Visible forearm veins are exhausted after two ward attempts. The PDVF clinician maps a 3 mm cephalic vein at 1.0 cm depth and places a 22G PIV under ultrasound. Reasoning: the therapy is peripherally compatible, short, and non-vesicant; a PICC would add central-line risk without benefit. If the drug were a vesicant or therapy exceeded several weeks, the device plan would change.
Traps
Defining difficult access only by “number of attempts”; choosing a device before checking the prescription; exceeding scope; ignoring patient preference; and failing to escalate when no suitable peripheral vein exists.