Name of the Procedure:

• Common Name: Catheter Insertion
• Medical Terms: Infusion Catheter Insertion, Peripheral Inserted Central Catheter (PICC), Midline Catheter Insertion

Summary

The insertion of an infusion catheter involves placing a flexible tube into a vein, either peripherally, centrally, or at the midline, to allow for medication administration, fluid infusion, or nutritional support. This procedure is specifically for uses other than hemodialysis.

Purpose

This procedure is used to:

• Administer long-term IV antibiotics, chemotherapy, or total parenteral nutrition (TPN).
• Provide fluids and medications when peripheral veins are not viable.
• Draw blood for testing without repeated needle sticks. The goal is to facilitate prolonged and reliable venous access for medical treatment.

Indications

• Patients requiring frequent or long-term IV therapy.
• Inadequate peripheral venous access.
• Conditions such as severe infections, cancer, or chronic illnesses requiring ongoing infusion therapy.

Preparation

• Patients may be instructed to fast for a few hours prior to the procedure.
• Certain medications might need to be paused or adjusted.
• A complete blood count (CBC), coagulation profile, and other relevant tests may be required to ensure it is safe to perform the procedure.

Procedure Description

1. Preparation: Patient is positioned comfortably, and the insertion site is sterilized.
2. Local Anesthesia: Applied to numb the insertion area.
3. Insertion: A needle is used to access the vein; then, a guidewire is introduced through the needle.
4. Catheter Placement: The catheter is slid over the guidewire into the vein, and the guidewire is removed.
5. Securing the Catheter: The catheter is secured in place, and a sterile dressing is applied.

Tools used include:

• Sterile drapes and gloves
• Local anesthetic
• Needle, guidewire, and catheter kit
• Sterile dressing

Duration

The procedure typically takes about 30 minutes to an hour.

Setting

• Hospital ward or ICU
• Outpatient clinic
• Surgical center

Personnel

• Interventional Radiologist or specially trained nurse or physician
• Nurse for patient care and assistance

Risks and Complications

Common risks:

• Minor bleeding
• Bruising Less common risks:
• Infection at the insertion site
• Thrombosis (blood clot)
• Catheter misplacement Management includes monitoring, antibiotics for infection, and potentially catheter repositioning.

Benefits

• Reliable, long-term venous access
• Reduced need for multiple needle sticks
• Improved comfort for patients with long-term treatment needs Benefits are often realized immediately following insertion.

Recovery

• Patients are monitored for any immediate complications.
• Instructions include keeping the insertion site clean and dry.
• Regular follow-up appointments to check catheter function and site condition. Expected recovery time is minimal, usually a few hours of observation.

Alternatives

• Peripheral IV lines (short-term solution)
• Implanted ports (more invasive, suitable for very long-term use)
• Subcutaneous injections While alternatives have their own benefits, a catheter provides a balance of ease of insertion and duration of use.

Patient Experience

During the procedure, patients might feel a prick from the needle and some pressure. Post-procedure, mild discomfort at the insertion site is common, but it is generally well-managed with over-the-counter pain medication. Overall, most patients find the procedure tolerable and experience relief with reduced need for further needlesticks.