Vascular Access

Appropriate vascular access devices (VADs)  are chosen according to patient characteristics and therapy requirements. VADs can be described as tunneled or non-tunneled and specifications may include the device materials, number of lumens and catheters, external catheter diameter and shape, internal luminal diameter(s) and shape(s), number and size of holes, configuration of the catheter tip, presence of subcutaneous cuff, method of attachment to skin and/or subcutaneous tissues, external interface, coating with antibiotics, and flow characteristics. The anticipated duration of therapy, condition of the patient, and risk for phlebitis can drive the decision about the appropriate vascular access device. Tunneled catheters travel through subcutaneous tissue before entering an access vein. Tunneled catheters can also have a subcutaneous self-sealing device to allow intermittent access in patient with longer-term vascular access needs. Table 3 shows general characteristics of selected VADs.

Table 3. Categories of VADs