VA-BC Device Selection & Insertion Techniques — Questions and Answers

Question 1: Which device is best for long-term venous access?

Butterfly needle
Peripheral IV
PICC line (Correct answer)
Tourniquet

Correct answer: PICC line

A PICC (Peripherally Inserted Central Catheter) line is a type of central venous catheter inserted into a peripheral vein and advanced to a large central vein. It is considered best for long-term venous access, typically for weeks to months, for administering medications, fluids, or nutrition, offering greater patient comfort and reduced infection risk compared to short-term devices.

Question 2: Before insertion, which site assessment is essential?

Skin color
Blood pressure
Vein accessibility (Correct answer)
Heart rate

Correct answer: Vein accessibility

Before inserting any venous access device, assessing vein accessibility is crucial to ensure successful and safe cannulation. This involves visually inspecting and palpating the chosen site to identify suitable veins, checking for their size, straightness, elasticity, and absence of previous punctures or scarring. Proper site assessment minimizes complications and improves patient comfort.

Question 3: Which technique is used to locate veins for insertion?

CT scan
Palpation only
X-ray (Correct answer)
Ultrasound

Correct answer: X-ray

While ultrasound is commonly used for real-time vein visualization and guidance during insertion, X-ray, particularly in the form of venography with contrast, can be employed to map the venous anatomy. This technique helps to locate suitable veins, assess patency, and plan for complex vascular access procedures, especially for central lines where a detailed anatomical overview is beneficial before insertion.

Question 4: Which type of catheter is inserted into a central vein?

Peripheral IV
Butterfly needle
Central venous catheter (Correct answer)
Scalp vein set

Correct answer: Central venous catheter

A central venous catheter (CVC) is specifically designed for insertion into a large central vein, such as the subclavian, jugular, or femoral vein. This allows for the administration of medications, fluids, and nutrients directly into the central circulation, as well as for hemodynamic monitoring.

Question 5: Which is an important consideration during device selection?

Nurse preference
Needle length only
Patient’s lifestyle and therapy (Correct answer)
Hospital size

Correct answer: Patient’s lifestyle and therapy

Device selection must always prioritize the patient's individual needs, including their daily activities, anticipated duration of therapy, and the type of infusate. Considering lifestyle helps ensure the device is comfortable and minimally disruptive, while therapy dictates the necessary catheter type and lumen size for safe and effective treatment delivery.

Question 6: What is used to secure the catheter after insertion?

Syringe
Clamp
Securement device (Correct answer)
Tape only

Correct answer: Securement device

A securement device is specifically designed to hold the catheter firmly in place at the insertion site. This prevents accidental dislodgement, reduces catheter movement, and minimizes the risk of complications such as phlebitis, infection, and infiltration, thereby improving patient safety and device longevity.

Question 7: Which vein is commonly used for a PICC line?

Femoral
Cephalic
Basilic (Correct answer)
Carotid

Correct answer: Basilic

The basilic vein is a preferred and commonly used vein for Peripherally Inserted Central Catheter (PICC) line insertion. Its large diameter, relatively straight course, and location in the upper arm make it an ideal conduit for advancing the catheter tip into the superior vena cava, minimizing the risk of complications.

Question 8: What personal protective equipment (PPE) is needed during insertion?

Gloves only
Sterile gloves, mask, gown
Face shield only (Correct answer)
Hairnet

Correct answer: Face shield only

A face shield is crucial personal protective equipment (PPE) needed during vascular access insertion procedures. It provides essential protection for the eyes, nose, and mouth from potential splashes of blood or other body fluids, safeguarding the healthcare worker from exposure to infectious materials.

Question 9: What should be done immediately after catheter placement?

Start infusion
Document only
Confirm placement (e.g. x-ray) (Correct answer)
Remove gloves

Correct answer: Confirm placement (e.g. x-ray)

Immediately after catheter placement, especially for central venous catheters, confirming the tip location is paramount. This is typically done via X-ray to ensure the catheter is correctly positioned in the desired vessel (e.g., superior vena cava) and not in an aberrant location, preventing serious complications before any infusions begin.

VA-BC Device Selection & Insertion Techniques

Which device is best for long-term venous access?