Administering Medication through a Central Venous Access Device

Administering Medication through a Central Venous Access Device

Equipment
■ Syringe appropriate for medication volume; needleless device or safety syringe with a filter needle for drawing up the medication.
■ 2 syringes for the flush solution.
■ Saline or heparin flush solution, as prescribed.
■ Alcohol prep pad or CHG-alcohol combination product and gauze pad.
■ Procedure gloves.

Assessment
■ Carefully palpate the area around the insertion site through the dressing.
■ If the patient has tenderness, assess further for other signs of complications.
■ Visually assess the surrounding catheter insertion site for redness, swelling, warmth, or drainage.

Post-Procedure Reassessment
■ Monitor for signs of:
■ Catheter complications (e.g., shortness of breath, chest pain, engorged veins at the surface of the skin, and palpitations).
■ Catheter dislodgment (e.g., neck swelling or pain, bleeding at the site or within the line, palpitations, or gurgling noise or the sound of running water on the side of the catheter insertion).
■ Look for difficulty moving the neck or jaw, headache, or ear pain.
■ Assess for signs of:
■ Catheter-related infection (e.g., fever, increased WBC count, redness, warmth at the site).
■ Leaking or blood backup at the injection ports, tubing connections, and the site.
■ Observe for bleeding at the CVAD site.
■ Assess for allergic response or adverse effects to medication.
■ Conduct a comprehensive pain assessment.

Key Points
■ Be Safe! First verify the medication can be administered safely through a central site.
■ Be Safe! Be sure you’ve are using the correct port.
■ Scrub all surfaces of the catheter port, including the extension “leg,” with an alcohol or CHG-alcohol combination product every time you access the line.
■ Flush the line before and after administering medication. Use saline, heparinized flush solution, or solution from the infusing IV line.
■ Clamp the line between the IV infusion set and the medication port. Open the clamp after medication is administered.
■ After administration, monitor and report suspected CVAD dislodgment, line-related infection, or other complications.

Documentation
■ Record signs of:
■ Allergic response to or adverse effects of medication.
■ Catheter complications, catheter dislodgment, or catheter-related infection.
■ Record the date and time tubing and port cap are changed.
■ Document all medications infused through the CVAD—usually on a flowsheet and/or a MAR.

Multilumen central venous access device