Central Line Catheters

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A description of some of the types of central line catheters out there

Comments

propofolau says:

No problems – I think it was just an oversight, but it's nice to acknowledge that everyone has responsibility and accountability to know the correct ways to use their equipment safely and effectively. Thank you for considering my comments and your desire to make edits to your video. I appreciate that.

propofolau says:

Thanks for your reply. My comments were generally focusing on the safety aspect, but also the educational considerations when making youtube videos that novices may also be viewing… I guess we need to be acutely aware that "I watched/learned it on YouTube" is not a satisfactory or empirically-validated platform for good adult learning, and often highlights extremely variable clinical practices (both good, bad, and everywhere in between). In answer to your replies; 1) My apologies to you on the PSI statement; you are correct (I missed you saying it) – however, you still call it a 'Cordis', which it is not. The term Cordis refers to another brand of product that is not shown in this video. This is a common misrepresentation due to the various brands and configurations available, and so everything is often referred to as 'the same thing'. This frequently happens also with clinicians referring to a subclavian catheter, when it's clearly inserted in the axillary vein (infraclavicular fossa) – but that's a story for another time! 2) It looks as though you may have activated the locking mechanism when adding the SLIC, however, it is unclear and quite difficult to see on the video – and it's not mentioned in the voiceover, which is more really my point. The use of a regular central venous catheter (without the companion device locking hub) is, unfortunately, a commonplace wrongdoing, and it is not without risk. e.g: think of the repositioning/movement of an ICU, inotropic-dependent patient who has their CVC accidentally removed because it has not been correctly locked and secured properly. The loss of vascular access could be catastrophic. The risks are very real. #3) While it's difficult to determine every clinical scenario around accidental catheter removal from the PSI, there is ALWAYS a potential risk to the patient. One thing I will say about the hemostatic valve is that if a device has been removed from the PSI, then an occlusive needle-free device/end cap should be attached to prevent any unwarranted risks of positive or negative movement through the valve. It's all about safety and prevention of complications in this case. Thank you for the dialogue – it is important that all clinicians viewing this video, regardless of their levels of experience, want to learn and ensure appropriate patient safety considerations in all aspects of central venous catheterization and are aware of the correct use of the devices they chose to insert into their patients. There is a responsibility of everyone to be familiar with their kit and how it works.

propofolau says:

I just came across this video of yours. Now somewhat older, I would like to address some issues that is still relevant in today's clinical settings. Please ensure you are teaching the correct way to use the "companion" pieces with the PSI – it is not a "Cordis" – that is a brand name only. The correct name of this device is a Percutaneous Sheath Introducer (PSI). The SLIC locking mechanism was not addressed or how to activate it in your video – this is a key safety issue for ALL clinicians using these devices and everyone needs to be precisely educated on the appropriate and correct way to use these devices together. The companion pieces (SLIC and other multi-lumen configurations) all have the locking mechanism to prevent air entry into the system through the hemostatic valve, and to prevent unwanted accidental removal of the companion devices. Patient safety is paramount always – so please ensure that you understand how these devices work together and how to use them correctly before educating others – the lack of attention to safety in this video opens a serious number of clinical concerns and it should be noted by clinicians who are turning to YouTube for education. Please always check with the manufacturer or the instructions for use of the device before using unfamiliar equipment or to ensure you have the correct components/companion devices.

Shine Preet says:

Very helpful … thank you

Riyadh Alzahrani says:

Very helpful, thank you bro

sayed jubran says:

Excellent iformative valuable tutorial.Thank you.

PainH8er says:

Great, and thanks for the compliment.

eurah3 says:

Very helpful and informative. You make complicated things a lot easier to understand. Thanks a lot!

PainH8er says:

I'm not quite sure that I followed all of your comments, but thank you for your interest!

alberto jose cuenca says:

Sir thank you very much for very informative videos. It really helps me a lot specially in my profession as an anesthesia assistant where we rarely experience CVP insertion. I dont have the skills to assist the anesthetist thats why I rely more on educational materials. Sir, can I request for video on preparing on how to avoid bubbles inside the CVP tubing and priming of CVP line. …thank you very much

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