![]() ![]() Fortunata Dabu is a nurse clinician at Advocate Good Samaritan Hospital. Barbara Berger is a faculty member at the University of Illinois at Chicago College of Nursing and consults on evidence-based practice and clinical research. In addition to administration of fluids and medications, these devices allow painless collection of blood Authors Mary Sue Dailey is a clinical nurse specialist at Advocate Good Samaritan Hospital in Downers Grove, Illinois. ![]() Central venous catheters are available in a variety of sizes and lengths and can have single or multiple lumens that terminate at either staggered or “coterminal” locations along the catheter length (Figures 1 and 2). central venous access device (CVAD) often seen in patients needing intermittent central venous access. Distal port Medial port Proximal port Figure 2 Triple-lumen central venous catheter with staggered exit sites. Figure 1 Cross sections of distal tips of peripherally inserted central catheters. 5, OCTOBER 2014 Downloaded from at CLEMSON UNIVERSITY on Novem27 Table 1 Nursing practice survey on central venous access devices When obtaining a blood specimen from a central venous access device. Implanted ports are another type of ©2014 American Association of Critical-Care Nurses doi: CriticalCareNurse Vol 34, No. ![]() More distal veins such as the basilic or brachial veins can also be used for central venous access by using a peripherally inserted central catheter (PICC). Central venous access refers to cannulation of the internal jugular, subclavian, or femoral vein. Blood collection methods may include capillary finger stick, venipuncture, or specimen retrieval from arterial or central venous vascular access devices. Many of these diagnostic tests involve the collection of single or multiple blood specimens. 2014 34:27-42) H ospitalized patients undergo a variety of diagnostic tests to monitor the course of illness and their response to medications and treatments. However, obtaining the specimen from the heparin infusion port resulted in significantly higher aPTT values. CONCLUSIONS Use of this protocol resulted in similar aPTTs when the CVAD specimen was not obtained from the heparin infusion port. The median aPTT difference when the CVAD specimen was obtained from the heparin infusion port was -20.5 seconds, compared with -0.1, -3.0, and -0.2 seconds for specimens from a port proximal to, distal to, or coterminal with the heparin infusion, respectively (P =. 32) was significantly associated with the difference in aPTT. Neither length of time heparin was turned off (P =. RESULTS The mean aPTT difference (peripheral aPTT minus CVAD aPTT) was -7.3 seconds (P =. METHODS Simultaneous blood samples (CVAD vs venipuncture) from 66 patients receiving continuous heparin infusions were compared. OBJECTIVES To determine if there is a difference in aPTT results between specimens collected from a central venous access device (CVAD) compared with venipuncture in patients receiving heparin infusions. Downloaded from at CLEMSON UNIVERSITY on NovemFeature Activated Partial Thromboplastin Times From Venipuncture Versus Central Venous Catheter Specimens in Adults Receiving Continuous Heparin Infusions MARY SUE DAILEY, MSN, APN-CNS BARBARA BERGER, RN, PhD FORTUNATA DABU, RNC, BSN BACKGROUND In patients receiving heparin infusions, variations in specimen collection technique may contribute to inaccurate measurements of activated partial thromboplastin time (aPTT). doi: 10.4037/ccn2014933 © 2014 American Association of Critical-Care Nurses Published online Subscription Information Information for authors Submit Manuscript E-mail alerts Critical Care Nurse is the official peer-reviewed clinical journal of the American Association ofCritical-Care Nurses, published bi-monthly by The InnoVision Group 101 Columbia, Aliso Viejo, CA 92656. Activated Partial Thromboplastin Times From Venipuncture Versus Central Venous Catheter Specimens in Adults Receiving Continuous Heparin Infusions Mary Sue Dailey, Barbara Berger and Fortunata Dabu Crit Care Nurse 2014, 34:27-41.
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