VABC Catheter Types 4 — Questions and Answers
Question 1: A non-coring Huber needle is required to access which type of vascular access device?
- Tunneled Hickman catheter
- Implanted port (Correct answer)
- PICC line
- Midline catheter
Correct answer: Implanted port
Huber needles have a deflected tip that cores the silicone septum of an implanted port without removing material, preserving the septum's integrity over hundreds of accesses.
Question 2: Which catheter is most appropriate for a neonate requiring umbilical venous access for emergency resuscitation medications?
- PICC line
- Umbilical venous catheter (UVC) (Correct answer)
- Tunneled CVC
- Intraosseous catheter
Correct answer: Umbilical venous catheter (UVC)
An umbilical venous catheter provides rapid central venous access via the umbilical vein in neonates, making it the first-line device in neonatal resuscitation.
Question 3: Antimicrobial-impregnated CVCs are typically coated with which combination of agents to reduce CLABSI rates?
- Heparin and saline
- Chlorhexidine and silver sulfadiazine, or minocycline and rifampin (Correct answer)
- Vancomycin and gentamicin
- Povidone-iodine and alcohol
Correct answer: Chlorhexidine and silver sulfadiazine, or minocycline and rifampin
Evidence-based antimicrobial CVCs use either chlorhexidine/silver sulfadiazine (external surface) or minocycline/rifampin (internal and external surfaces) to reduce biofilm and CLABSI rates.
Question 4: What is the key hemodynamic indication that distinguishes use of a pulmonary artery catheter (Swan-Ganz) from a standard CVC?
- Need for long-term IV antibiotics
- Direct measurement of pulmonary artery pressures and cardiac output (Correct answer)
- Administration of caustic medications
- Home parenteral nutrition
Correct answer: Direct measurement of pulmonary artery pressures and cardiac output
A pulmonary artery catheter (Swan-Ganz) advances through the right heart into the pulmonary artery, enabling direct measurement of hemodynamic parameters unavailable with a standard CVC.
Question 5: Which catheter characteristic is most important when selecting a device for continuous renal replacement therapy (CRRT)?
- Small French size for patient comfort
- High flow capability with large internal lumen diameter (Correct answer)
- Valved tip to prevent air embolism
- Antimicrobial coating
Correct answer: High flow capability with large internal lumen diameter
CRRT requires blood flow rates of 100-300 mL/min, necessitating a large-bore catheter with a high-flow lumen to prevent circuit clotting.
Question 6: A patient develops catheter tip malposition into the right atrium. What is the primary clinical concern?
- Catheter occlusion from low flow
- Cardiac arrhythmias and potential cardiac perforation (Correct answer)
- Increased risk of air embolism
- Loss of central venous pressure monitoring
Correct answer: Cardiac arrhythmias and potential cardiac perforation
A catheter tip in the right atrium can irritate the myocardium, causing arrhythmias, and carries a risk of cardiac wall perforation leading to tamponade.
Question 7: Which catheter material softens upon contact with body temperature, reducing the risk of vessel perforation?
- Stainless steel
- Thermoplastic polyurethane (Correct answer)
- Polyvinyl chloride (PVC)
- Silicone rubber
Correct answer: Thermoplastic polyurethane
Thermoplastic polyurethane catheters become softer and more pliable at body temperature, conforming to vessel anatomy and reducing mechanical trauma and perforation risk.
VABC Catheter Types 4
A non-coring Huber needle is required to access which type of vascular access device?