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Surgically implanted infusion ports are placed below the clavicle (infraclavicular fossa), with the catheter threaded into the heart (right atrium) through a large vein. Once implanted, the port is accessed via noncoring "Huber" needles inserted through the skin. The health care provider may need to use topical anesthetic before accessing the port.
The port access site is fixed at 5 cm below the midline of the clavicle and 9 to 10 cm lateral to the midline of the chest. Then, a 5 to 6 cm incision is made to create a subcutaneous tissue pouch for the placement of port access site. A tunnel is made from the port access site until adjacent to the internal jugular neck wound.
Once implanted, the port is accessed via a "gripper" non-coring Huber-tipped needle (PowerLoc is one brand, common sizes are 0.75 and 1 inch (19 and 25 mm) length; 19 and 20 gauge. The needle assembly includes a short length of tubing and cannula) inserted directly through the skin. The clinician and patient may elect to apply a topical ...
Catheter access, sometimes called a CVC (central venous catheter), consists of a plastic catheter with two lumens (or occasionally two separate catheters) which is inserted into a large vein (usually the vena cava, via the internal jugular vein or the femoral vein) to allow large flows of blood to be withdrawn from one lumen, to enter the dialysis circuit, and to be returned via the other lumen.
When the needle enters the vein, venous blood pressure generally forces a small amount of blood into the set's transparent tubing providing a visual sign, called the "flash" or "flashback", that lets the practitioner know that the needle is actually inside of a vein. The butterfly offers advantages over a simple straight needle. The butterfly's ...
The catheter is introduced into the vein by a needle (similar to blood drawing), which is subsequently removed while the small plastic cannula remains in place. The catheter is then fixed by taping it to the patient's skin or using an adhesive dressing. A peripheral venous catheter is the most commonly used vascular access in medicine.
Hickman lines may remain in place for extended periods and are used when long-term intravenous access is required. Long-term venous catheters became available in 1968, and the design was improved by Dr. John W. Broviac (b. 1942), a nephrologist based in East Lansing, Michigan , in 1973.
Both puncture needle and obturator engaged, allowing for direct insertion. C. Puncture needle retracted. Obturator engaged. Used for example in steady advancement of the catheter on a guidewire. D. Both obturator and puncture needle retracted, when the catheter is in place. E. Locking string is pulled (bottom center) and then wrapped and ...