VABC Catheter Types 3 — Questions and Answers
Question 1: What is the primary advantage of a power-injectable PICC over a standard PICC?
- It can be inserted without ultrasound guidance
- It is rated to withstand high-pressure contrast injection for CT scans (Correct answer)
- It requires no flushing protocol
- It has a longer dwell time than other PICCs
Correct answer: It is rated to withstand high-pressure contrast injection for CT scans
Power-injectable PICCs are constructed to tolerate high flow rates and pressures used during CT contrast injection, eliminating the need for a separate peripheral IV for imaging.
Question 2: An umbilical arterial catheter (UAC) tip should ideally be positioned at which vertebral level?
- T6-T9
- L3-L4
- T6-T9 (high position) or L3-L4 (low position) (Correct answer)
- C7-T1
Correct answer: T6-T9 (high position) or L3-L4 (low position)
UAC placement uses either a high position (T6-T9, above the celiac axis) or a low position (L3-L4, below the renal arteries) to avoid major vessel origins.
Question 3: Which catheter type is characterized by an open-ended tip that requires routine heparin flushing to maintain patency?
- Groshong catheter
- Standard non-valved CVC or PICC (Correct answer)
- PASV-valved catheter
- Pressure-activated safety valve catheter
Correct answer: Standard non-valved CVC or PICC
Standard non-valved CVCs and PICCs have open-ended tips that allow blood to reflux into the lumen, requiring heparin flushes to prevent clot formation.
Question 4: A peripherally inserted central catheter (PICC) tip should be confirmed at which anatomical location before use?
- Mid-subclavian vein
- Cavoatrial junction or distal superior vena cava (Correct answer)
- Axillary vein
- Right atrium midpoint
Correct answer: Cavoatrial junction or distal superior vena cava
PICC tips must be confirmed at the cavoatrial junction or distal SVC by chest X-ray or other imaging to ensure central placement before use.
Question 5: Which catheter is most commonly used for long-term total parenteral nutrition (TPN) in a home care setting?
- Non-tunneled subclavian CVC
- Tunneled cuffed catheter (e.g., Hickman) (Correct answer)
- Midline catheter
- Peripheral IV
Correct answer: Tunneled cuffed catheter (e.g., Hickman)
Tunneled cuffed catheters like the Hickman are preferred for home TPN because the Dacron cuff anchors the catheter and reduces infection risk over months to years.
Question 6: What material property of silicone catheters makes them preferred over polyurethane for certain long-term applications?
- Greater rigidity for easier insertion
- Higher biocompatibility and softer flexibility reducing vessel wall trauma (Correct answer)
- Resistance to power injection pressures
- Lower cost of manufacturing
Correct answer: Higher biocompatibility and softer flexibility reducing vessel wall trauma
Silicone is highly biocompatible, soft, and flexible, reducing mechanical trauma to the vessel endothelium and making it suitable for long-term implanted access devices.
Question 7: Which vascular access device is entirely implanted under the skin with no external component when not accessed?
- Tunneled CVC
- PICC
- Implanted venous port (Port-a-Cath) (Correct answer)
- Midline catheter
Correct answer: Implanted venous port (Port-a-Cath)
Implanted venous ports are completely subcutaneous, with a reservoir accessed percutaneously through the skin using a non-coring (Huber) needle.
VABC Catheter Types 3
What is the primary advantage of a power-injectable PICC over a standard PICC?