Accessing CVADs for critically ill patients can be a lifesaving tool that can be used by ACPs. However, this procedure is not without risk and should only be performed if IV access is unobtainable.

Recall from our teaching on IO access that SWORBHP Medical Council defined as IV attempt as applying a tourniquet, then looking and feeling for a vein. The same applies for CVAD access. Please also document your findings on IV attempt, so the rationale for CVAD access is clear.

A non-exhaustive list of potential complications from utilizing a CVAD is as follows:  The line being non-functioning, or infected (maybe this is the cause of the sepsis the patient is experiencing).  There is also risk of air embolism, introducing infection and causing hemorrhage (recall that units may have instilled heparin).

Interested in knowing more about CVAD access? Stay tuned for an upcoming SWORBHP Podcast on this very topic.

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