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CARE OF PEDIATRIC CENTRAL CATHETERS Type of Line CVC Catheter Broviac Catheter Groshong Catheter Venous Access Ports Peripherally Inserted Central Catheter (PICC) Purpose Used for short-term central line access. Used for long-term (months to years) central line access. Used for long-term (months to years) central line access. Used for long-term (months to years) central line access. Used for intermediate length therapy – not to exceed 120 days. Lumen/Port Size Port Utilization Used for fluid administration, blood product administration, blood drawing, parenteral nutrition, and CVP monitoring. Catheter size varies from 4-7 Fr. And length varies from 5-30 cm. Check catheter lumen for dead space volume. #1 (distal): blood product administration, blood draws, and CVP monitoring. #2 (proximal): parenteral nutrition and maintenance fluids. Used for fluid administration, blood product administration, blood drawing, parenteral nutrition, and long-term medications such as IV antibiotic therapy and chemotherapy. Broviac Catheter: there are multiple sizes used – 2.7, 4.2, 6.6 and 9.6 Fr. Sizes. Double lumen line Red Port (distal): blood product administration, blood draws, and CVP monitoring. White Port: parenteral nutrition and maintenance fluids. Used for fluid administration, blood product administration, blood drawing, parenteral nutrition, and long-term medications such as IV antibiotic therapy and chemotherapy. There are multiple sizes of Groshong catheters used – 3.5, 5.5, 7.0 and 8.0 Fr. Sizes. Double lumen line Red Port (distal): blood product administration, blood draws, and CVP monitoring. White Port: parenteral nutrition and maintenance fluids. Used for fluid administration, blood product administration, and blood drawing. Parenteral nutrition may be administered as well as long-term medication and chemotherapy. Pas-ports are placed in antecubital and used for CF patients. They may be double lumen. The size of the port depends on the size of the catheter placed. Most ports used for pediatric patients have a 6.6 French catheter size Double lumen ports: occasionally an older child will have a double port placement. May also be a pass-port Use the larger port for blood product administration and draws. The smaller port can be used for parenteral nutrition, medications and maintenance infusions. Used for fluid administration, long-term antibiotics and blood product administration. Blood drawing may be done if the catheter is larger than 3.0 Fr. Most pediatric catheters are less than 3.0 Fr. TPN and IL may be administered as long as the tip of the catheter is in the SVC. The catheter sizes vary. The Fr. Size ranges from 1.9 to 5.0 (16-22 gauge). Most pediatric patients have Fr. Size 1.9 (infants) to 2.8. The internal volume ranges from 0.04 ml to 0.34 ml. PICC’s are single lumen ports only. _________________________________________________________________________________________________________________ Title: Venous Access Device Owner: Clinical Education Department Effective Date: 07/27/05 Page 14 of 25
CARE OF PEDIATRIC CENTRAL CATHETERS Type of Line CVC Catheter Broviac Catheter Groshong Catheter Venous Access Ports Peripherally Inserted Central Catheter (PICC) Catheter Access Irrigation Irrigate each port with Heparin flush concentration between 10- 100 units/cc. Determinations based on patient’s weight and diagnosis. All central lines should have a needle-less access cap on each access port. Only access lines through the needle-less access cap. The needle-less access cap should be cleansed with three alcohol swabs for 60 seconds prior to access. Maintenance Flushing: CVC: Heparin flush 1 cc/port every 24 hours. Medications: 1-3 cc flush with NaCl before and after medication. Follow with Heparin flush (CVC 1 cc). Maintenance Flushing: Heparin flush 1-3 cc/port every 12 hours. Medications: 5 cc flush with NaCl before and after medication. Follow with 1-3 cc Heparin flush. Maintenance Flushing: NaCl 10 cc flush every 7 days when not in use. Medications: NaCl 10 cc flush before and after medications. Only use a non-coring (Huber) needle for access. Maintenance Flushing: Heparin flush 5 cc every 4 weeks when not in use. Medications: 10-20 cc flush with NaCl before and after medication. Follow with 5 cc Heparin flush. See access for CVC, Broviac, and Groshong catheters. Maintenance Flushing: Heparin flush 1 cc q 12 hours. Medications: 5 cc flush with NaCl before and after medication. Follow with 1 cc Heparin flush. Utilize pulsatile flushing to prevent clot and fibrin formation. TPN: (discontinuing) Flush with 5-10 cc of NaCl followed by Heparin flush (1 cc). TPN: (discontinuing) Flush with 5-10 cc of NaCl followed by 1-3 cc Heparin flush. TPN: (discontinuing) Flush with 20 cc of NaCl before and after medications. TPN: (discontinuing) Flush with 10-20 cc of NaCl followed by 3-5 cc Heparin flush. TPN: (discontinuing) Flush with 5-10 cc of NaCl followed by 1 cc Heparin flush. Blood (draw or administration): flush with 3-5 cc NaCl followed by Heparin flush ( 2 cc). Blood (draw or administration): flush with 5-10 cc NaCl followed by 1-3 cc Heparin flush. Blood (draw or administration): flush with 10 cc NaCl before and after blood draw or administration. Blood (draw or administration): flush with 20 cc NaCl followed by 5 cc Heparin flush. Blood (draw or administration): flush with 5-10 cc NaCl followed by 1 cc Heparin flush. PSCU, PEDS, PICU PICC lines will have a continuous heparin infusion (1 unit/cc) at 2cc=2 units/hr. if no other fluid is infusing. From Lexi-Comp’s Pediatric Dosage Handbook, p. 559, “Line flushing: When using daily flushes of heparin to maintain patency of single lumen or double lumen central catheters, 10 units/ml is commonly used for younger infants,(i.e.
Page 1 and 2: Applies To: All HSC Hospitals, CRTC
Page 3 and 4: 12. Patient Education 12.1. Instruc
Page 5 and 6: KEY WORDS Broviac Catheter, Central
Page 7 and 8: ATTACHMENT A: LONG ARM CATHETER (LA
Page 9 and 10: 22. Clean and apply a dressing to t
Page 11 and 12: ATTACHMENT C: LONG ARM CATHETER LEN
Page 13: ATTACHMENT D: CARE OF PEDIATRIC CEN
Page 17 and 18: CARE OF PEDIATRIC CENTRAL CATHETERS
Page 19 and 20: ATTACHMENT F: CARE OF ADULT CENTRAL
Page 21 and 22: Type of Lines Irrigation: use Hepar
Page 23 and 24: ATTACHMENT G: QUICK REFERENCE FOR V
Page 25: ___________________________________

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