Читать книгу Emergency Medical Services - Группа авторов - Страница 214

In the prehospital setting, dialysis catheters, infusion ports, and other long‐term artificial structures should not be considered as first‐line options for gaining vascular access unless carefully considered by the medical director and other relevant consultants. The health of these difficult access patients often depends on frequent IV access and medication administration. Improper use of these routes may result in serious consequences. Alternative forms of vascular access or medication routes should be considered. In the case that the EMS clinician must access these types of catheters, special attention must be paid to the specific technique for accessing each device found in the community, as subtle but important differences exist across a range of device types and manufacturers. The most important tenets of accessing an existing device revolve around maintaining a sterile procedure, as line infection often leads to substantial morbidity. Additionally, many indwelling catheters are filled with a fluid such as saline or heparin when not in use. Care must be taken to properly remove and discard this solution to avoid contamination of blood samples or systemic administration of an active medication.