Establishing Vascular Access in a Difficult Intravenous Access Patient

A 67-year-old male with recent diagnosis of septic shock secondary to pneumonia is now recovering and no longer in need of central venous access. Unfortunately, the nursing staff were unable to establish peripheral IV access after several attempts. The learner will evaluate the patient, review medical history, and establish vascular access using the appropriate technique.

Learning Objectives

– Learner understands indications for midline line placement
a. The learner will have to identify the appropriate vascular access device to use for insertion based on the clinical scenario provided (e.g., PICC vs. midline vs. PIV)

– Learner demonstrates appropriate anatomical site selection for midline placement
a. The learner scans anatomical sites on the upper arm with ultrasound to identify appropriate veins (basilic, brachial, or cephalic veins)

– Learner performs complete vascular access assessment

– Learner demonstrates correct sequence for inserting midline
a. The learner will have to systematically insert the midline per recommended skills checklist

– Learner documents the completion of the vascular access procedure
a. The learner will need to indicate that documentation has been completed