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Vascular Access in Children in Bhubaneswar

Vascular Access in children

Vascular Access in Children in Bhubaneswar

Vascular Access in children
Vascular access is frequently required in hospitalized children to diagnose and symptomatically treat certain diseases. Venous access is used in anaesthesia, resuscitation, critical care for fluid, and medication delivery. Arterial access is performed in major surgeries and critically ill children where blood pressure monitoring and blood gas sampling are required, while Intraosseous access through the bones is used when intravenous access is not suitable.
Vascular access devices (VADs) are inserted into the veins through peripheral or central vessels for diagnostic or therapeutic reasons, such as blood sampling, central venous pressure readings, administration of medication, fluids, total parenteral nutrition (TPN) and blood transfusions. A peripherally inserted central catheter (PICC) is a thin, soft, flexible tube which works as an intravenous (IV) line through which medications are infused. Blood for laboratory tests can also be withdrawn from a PICC.

Why choose Manipal Hospitals
Our state of the art Cath Lab has a comfortable ambience for children who require permanent vascular access procedures. Our paediatric vascular specialists perform the whole gamut of vascular diagnostic and therapeutic procedures such as cardiac catheterization, haemo-dialysis, and for emergency pulmonary infections, in high levels of sterile conditions and patient comfort.
 

FAQ's

Vascular Access holds immense importance in paediatric anaesthesia and critical care settings as it facilitates the administration of fluids, medications, and blood products essential for resuscitation, perioperative management, and ongoing patient care. Paediatric patients often require vascular access for various procedures, including surgery, intensive care unit (ICU) stays, and emergency interventions. Therefore, mastering vascular access techniques is considered fundamental for anesthesiologists and critical care practitioners.

Obtaining Vascular Access in paediatric patients presents several challenges due to anatomical differences, small vein sizes, and physiological variability. Additionally, factors such as patient anxiety, discomfort, and limited cooperation further complicate the process. Healthcare providers must navigate these challenges while ensuring patient safety and minimising procedural discomfort.

Vascular Access in paediatric patients can be achieved through various means, including peripheral venous access, central venous access, arterial access, and intraosseous access. Each type of access serves specific purposes, depending on the clinical scenario and the patient's condition. Peripheral venous access is commonly used for routine procedures and medication administration, while central venous access may be necessary for more invasive interventions and prolonged therapy. Arterial access enables continuous blood pressure monitoring and blood gas sampling, while intraosseous access serves as an emergency access route in critical situations.

Reducing anxiety and pain during Vascular Access procedures in children is paramount for optimising patient comfort and cooperation. Strategies include parental presence, distraction techniques tailored to the child's age and preferences, and the use of local anaesthesia creams containing lignocaine or prilocaine applied prior to the procedure. Additionally, non-pharmacological interventions such as sucrose administration for neonates and swaddling can help alleviate discomfort.

To ensure procedural safety and infection control during Vascular Access procedures in paediatric patients, healthcare providers should adhere to established protocols and guidelines. This includes thorough skin preparation using antiseptic solutions such as chlorhexidine or povidone-iodine, adherence to aseptic techniques during catheter insertion, and the use of transparent non-occlusive dressings for monitoring. In cases where longer dwell times are anticipated, chlorhexidine-impregnated dressings may be preferred to reduce the risk of infective complications.

Antibiotic prophylaxis is generally not indicated for routine Vascular Access procedures in paediatric patients. However, it may be considered in specific circumstances, such as implantable port placements or in immunocompromised and high-risk neonates, where the risk of infection is elevated. Healthcare providers should carefully weigh the benefits and risks of antibiotic prophylaxis on a case-by-case basis and adhere to institutional guidelines and recommendations.

Parental presence during Vascular Access procedures in children can provide comfort and reassurance, helping to reduce anxiety levels for both the child and the parent. Additionally, distraction techniques tailored to the child's age and preferences, such as toys, music, or electronic devices, can divert attention away from the procedure, further minimising anxiety and discomfort.

Healthcare providers consider various factors when determining the most appropriate type of Vascular Access for paediatric patients, including the urgency of the intervention, the anticipated duration of access needed, the patient's age and size, and their underlying medical condition. Peripheral venous access is often preferred for short-term needs, while central venous access may be indicated for long-term therapy or when peripheral access is challenging to obtain.

Complications associated with Vascular Access procedures in paediatric patients may include infection, thrombosis, infiltration, and catheter malposition. Healthcare providers can mitigate these risks by adhering to strict aseptic techniques, utilising appropriate catheter securement devices, regularly assessing Vascular Access sites for signs of complications, and promptly addressing any issues that arise.

The duration for which the vascular access device remains in place depends on the type of device and the reason for its use. Peripheral IVs are usually short-term, while central lines, PICCs, and ports are intended for longer-term use.

The procedure may cause some discomfort, but local anaesthetics or numbing creams are often used to minimise pain. Healthcare providers will work to make the process as comfortable as possible for your child.

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