The Vessel Health and Preservation Protocol provides the steps to ensure timely, reliable access from any
portal of hospital entry using the device most specific to the patient's medical condition that helps preserve vessel health.
There are three main types of CVC devices: Nontunneled, tunneled and implanted ports. Each of these devices
has an intended purpose and should be used according to the manufacturer's instructions for use and in accordance with national
standards of practice or guidelines (INS or CDC).
Selection of the most appropriate device for a specific patient is aided using the Vessel Health and Preservation Right Line Tool.
The Right Line Tool reviews the diagnoses/conditions that apply to the patient and guides you through a series of decisions that lead
to the most appropriate device. If more than one device is suggested, you should choose the device that allows for the safest delivery
of all prescribed medications. The protocol then guides you through the Right Patient Tool to determine if the patient has risk factors,
complications or a medical history that contraindicates use of the indicated line (10)*.
For example, patients in critical condition need a device with multiple access ports to allow high flow gravity infusions such as a
triple lumen (and perhaps antimicrobial) CVC. Patients undergoing dialysis need to preserve vasculature for long term access and should
not receive a peripherally inserted central catheter (PICC). While a PICC may be indicated based on the Right Line Tool, the Right
Patient Tool provides a more in-depth patient analysis and indicates the best initial device to be a dual dialysis catheter with an
additional CVC infusion port, or a traditional dialysis catheter (10)*.
In situations where a patient requires parenteral nutrition, a device enabling maximum dilution of the intravenous nutrition is necessary.
If nutrition is required for only a few days and a PICC is contraindicated, a centrally inserted CVC is acceptable. Patients with chronic
nutritional needs require an implanted port. Some acute patients who require irritating medications or prolonged infusion therapy may also
benefit from use of a central venous access device (10)*.