Types and uses of current prevailing venous access devices
| TYPE OF DEVICE | WHEN TO USE | WHEN TO AVOID |
|---|---|---|
| Peripheral devices | ||
| •PIV | For short-term access (up to 96 hours) | When access is needed for more than a few days |
| •Midline catheter | Rarely used because of growing popularity of PICCs | When access is needed for longer than 1 month or when vesicant medications are involved |
| Central devices | ||
| •PICC | For medium-term access (up to 6 months) and especially for antibiotics, TPN, chemotherapy, transfusions, and frequent blood sampling | When long-term (or permanent) access is required
Not recommended for dialysis (or predialysis) patients |
| •Non-tunneled central catheter | For short-term access when PIV is not suitable, and especially for resuscitation and central venous pressure monitoring | When access is required for more than a few days (use a tunneled catheter instead) |
| •Tunneled central catheter | For frequent long-term access, and especially for TPN, transfusions, and frequent blood sampling Can be used when PICC line is contraindicated or not possible | When access of shorter duration is required (consider an implantable port if access is to be less frequent) |
| •Implantable port | For infrequent access on a long-term basis or when lifestyle concerns make one of the other options less appealing | When venous access is regularly required (frequent needle pokes would be uncomfortable for the patient) |
PICC—peripherally inserted central catheter, PIV—peripheral intravenous, TPN—total parenteral nutrition.