Central venous access devices. Part 1: devices for acute care.

This two-part article provides an overview of central venous access devices (CVADs) for acute and longer-term use. Part 1 reviews the classifications of vascular access devices before focusing on CVADs for the acute care setting. The rationale for selecting the central route is explained. Clinical indications for the use of CVADs in acute care are discussed and an overview of the related therapies is provided. The practical procedure for insertion of an acute care CVAD is explained using a step-by-step approach. Infection control aspects of device insertion are highlighted and recommendations from epic2 are incorporated into the practical procedure. Key aspects of CVAD care are discussed and the procedure for removal of non-tunnelled central catheters is presented. Part 2 focuses on the use of CVADs for longer-term care.