Small gauge central venous catheters and right atrial catheters.

Abstract

Abstract In conclusion, the silastic catheters are viable alternatives to peripheral venous access in patients with impaired peripheral venous integrity secondary to prior chemotherapy, extravasation, circulatory impairment, and/or phlebitis. Careful planning in anticipation of the patient's long-term vascular access needs will enable earlier placement and may reduce complications secondary to chemotherapy administration via impaired peripheral veins. The oncology nurse has a primary role in the assessment of the patient's need for central venous access. Frequency of blood sampling, chemotherapy administration schedules, requirements for blood products and intravenous medications and fluids are all influencing factors. Providing information to the patient and family about the various vascular access devices is an important role of the oncology nurse as well. Assessment of the patient and family member's abilities to care for the catheter, the home environment, and follow-up needed will help plan later care. Early patient and family education, once a vascular access device is selected, will promote patient independence at home. Meticulous catheter care by the oncology nurse when the patient is hospitalized and careful follow-up of the patient's management of the catheter will help ensure the greatest longevity and lessen the incidence of complications. They are, in one patient's words, a “life-line,” and should always be respected. Oncology nurses are in the forefront of role-modeling this respect.