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Referrals

Vascular access is a nurse led service.  Not all patients are

suitable for referral.

Inclusion Criteria:

 

PERIPHERAL CENTRAL VENOUS CATHETER (PICC)

 

There are no restrictive exclusion for PICC line insertion with VAS GGC. You may consider omitting low molecular weight Heparin or correct low platelet levels in the unlikely event that a PICC line is unsuccessful and may require to be converted to a tunnelled line.

 

CUFFED TUNNELLED CENTRAL VENOUS CATHETER(TCVC)

  • APTT ratio must be equal to or lower than 1.6
  • PT no higher than 16
  • Platelets must be above 40 (if platelets between 30-40 VAS will consider placing a catheter with platelets running following discussion with medical staff).
  • Low molecular weight heparin (LMWH) must be omitted 24 hours prior to procedure
  • Patient is able to lie flat.

PATIENTS NOT SUITABLE FOR NURSE LED SERVICE

  • Known venous stenosis, SVC obstruction or central venous stent in situ
  • Significant mediastinal disease
  • Recent myocardial infarction (within 2 days)
  • Pacemaker in situ
  • Current pneumothorax

If patient has these symptoms please refer to interventional radiology service.

Patient Referral to the Vascular Access Service

 

All patient referrals are made via TrakCare. Please follow the process below:

  • Input the patients community health index (CHI) into trak.
  • Click on Episode Tree
  • Select current episode.
  • Click on 'New Request'
  • Under Imaging:
  • For PICC line insertion : Input 'IPICCI' into item box
  • For TCVC insertion input  'ITCVCI'
  • For TCVC removal 'ITCVCX'
  • For TCVC exchange 'ITCVCG
  • For Haemo-dialysis insertion ' ITUNDI'

For insertion of TCVC - all patients must have a recent Coagulation (Coag) and Full Blood Count (FBC) (within 2 weeks provided they have received no treatment)