What to Know About Vascular Access

Vascular access is a method of accessing the bloodstream for purposes like administering medication or dialysis. They’re usually suited for long-term use.

When a standard intravenous (IV) line isn’t enough to access the bloodstream, a vascular access device may be necessary. This could be because a deeper, larger vein needs to be accessed.

Vascular access is also a good option if you need ongoing care. They’re more durable and less prone to infection than IVs, so they can be used for longer periods of time.

Here’s what else to know about vascular access, including its uses and what the procedure entails.

What is it?

As the name suggests, vascular access is a method of accessing the vascular system in the body. It involves cutting into the skin to allow access to the vein.

Fluids can either flow in or out. Blood may then flow out of the body via a medical device (like a dialysis machine) and back into the body after treatment. Fluids, nutrients, or blood products may also be sent into the bloodstream.

Healthcare professionals often use it for purposes like administering medications or fluids to people who can’t consume them orally or need quick nutrition. They also use it to obtain blood samples or administer medications.

Reasons to have vascular access

Vascular access suits various purposes. Some common uses include:

• administering fluids, medications, and blood products
• drawing blood samples for diagnostic testing
• monitoring various physiological parameters
• administering nutrients for nutritional support
• facilitating dialysis for people with kidney failure

Vascular access vs. IV therapy

Technically, vascular access is a form of IV therapy. Your doctor may recommend vascular access over an IV line for the following reasons:

• Durability: Vascular access catheters are more durable and less vulnerable to blockages or infection than regular IV lines.
• Placement: Healthcare professionals often insert vascular access catheters into the largest central vein by the heart. They typically place IVs in smaller peripheral veins.
• Long-term use: Vascular access is created for longer-term or repeated use, whereas a standard IV is typically only necessary for short-term use.

Types of vascular access

\Various types of vascular access include :

• Arteriovenous fistulas (AVF): These are created by connecting an artery directly to a vein. They’re considered the best option for hemodialysis and come with a lower infection rate than other methods.
• Arteriovenous grafts (AVG): These are used when your veins are inadequate for AVF. For example, a vein may be too small, thin or have scarring or blockages. The doctor will place a synthetic tube between the artery and vein to support it.
• Central venous catheters: These are inserted directly into large veins in the neck, chest, or groin. They’re often used when immediate access is needed for dialysis. This method typically comes with a higher complication rate than other methods.
• Peripheral intravenous (IV) access: This is the most common type of vascular access for short-term use. The catheter is typically inserted in the veins of the hands or arms.
• Peripherally inserted central catheters (PICC): This is inserted in the arm with the tip ending in a central vein. They’re usually used for medium- to long-term treatments.
• Implanted ports: These ports are surgically placed under the skin. They’re reserved for long-term use, such as for chemotherapy.
• Intraosseous (IO) access: This involves inserting a needle directly into the bone marrow. It’s used in emergencies when other types of access may be challenging or not feasible.

When to contact a doctor

If you already have a vascular access device, contact your right away if you notice any of the following:

• signs of infection like redness, skin discoloration, soreness, pain, or swelling
• fever of 100.3°F (38.0°C) or higher
• bleeding from the access site
• decreased or absent blood flow in the fistula or graft
• swelling or coldness in the arm with the access
• numbness or weakness in the hand
• the catheter became dislodged

The bottom line

When typical IVs are insufficient, vascular access offers a deeper or longer-term solution.

Proper care and monitoring of vascular access devices is vital to avoid infection or other complications, so always follow your doctor’s instructions closely.