Pediatric emergency medicine trisk 4664 4664

Specific equipment is available for accessing tunneled and totally implanted indwelling CVCs ( Table 135.5 ) The medical office or ED that occasionally sees these children should have a prepared kit containing these items at hand FIGURE 135.8 Totally implantable venous access device TABLE 135.5 EQUIPMENT NEEDED TO ACCESS CENTRAL VENOUS CATHETERS Clamp or hemostat without teeth, possibly with rubber tips T-extension tubing with clamp 10-mL syringe of normal saline 10-mL syringe of heparin 10 unit/mL; 100 unit/mL Needleless injection caps 70% Alcohol or Chlorhexidine/Alcohol Procedure gloves for accessing a capped line; Sterile gloves to change the caps of access a port Dressing gauze and tape Transparent semi-permeable sterile dressing For implanted ports: Two tapered Huber noncoring needles, 20- and 22-gauge, in the appropriate length for the patient (3/4 in most commonly used)