Vascular access devices (VADs) such as central venous catheters, peripherally inserted central catheters (PICCs), implanted ports, dialysis catheters, and arterial catheters are used to infuse medications and fluids into the vascular system. Various accessories are used with VADs including administration sets, clamps, stopcocks, extension sets, and injection ports. Mechanical infusion devices such as elastomeric balloons and electronic infusion devices such as positive pressure pumps and gravity-based controllers can be used to deliver fluids through VADs.

1. Intravenous
therapy delivery
system

2. Vascular Access Devices:
A vascular access device (VAD) or catheter is a device
that is introduced through the skin, into the vascular
network, for the purpose of infusing parenteral solutions
and medications.

12.  Nontunneled and Noncuffed CVADs
 Peripherally Inserted Central Catheter
(PICC)
 Implanted Ports

19.  Dialysis and Pheresis Catheters: Dialysis and pheresis catheters are
rarely considered for routine infusion administrations.
 They are instead used for procedures where large volumes of blood need
to be treated for specific medical indications. They may be inserted at the
bedside or in the radiology or operating suite.
 The dialysis catheter is inserted and used for dialysis until a permanent
shunt can be inserted. A pheresis catheter may be inserted for
plasmapheresis procedures where large volumes of blood are filtered in
attempts to remove undesired plasma components

21.  Arterial-Venous Shunts:
Arterial-venous shunts are Gor-Tex or silicone-based devices
that are used to anastomose venous and arterial structures, usually
located in the arm, such as the radial artery and the cephalic or
brachial veins. These shunts are used for specific infusion and
exchange therapies and as VADs. When used for dialysis, the shunt is
accessed with a large-bore needle. Occasionally these access devices
can be used for other infusion therapies such as parenteral nutrition or
fluid rehydration

23.  Arterial Catheters:
Arterial catheters are used for two primary indications: Blood
pressure monitoring
Vascular access for obtaining blood samples.
The catheter is usually made from stiff material such as polyurethane
because it must withstand dwell time–limiting effects such as
kinking and softening. Peripherally located arterial catheters are
most commonly inserted into the radial artery and attached to
pressure transducers and monitors

25.  Hepatic Artery Catheters:
The hepatic artery catheter, is used to deliver
specific, or targeted, antineoplastic therapy.
Regionalized antineoplastic therapy is best
delivered by this route.

26.  Fluid Containers
 Administration Sets

27.  Clamps

28.  Stopcock—This is a manually operated device that is
used to direct the flow of an infus. Stopcocks are used
when multiple solutions are being infused. They have a
three-way or four-way mechanism, permitting infusions
to be connected at a common aperture, which is located
at the VAD’s hub.
 Extension set—Device used to add length as well as
additional side access ports to the existing
administration set.

31.  Multiflow adapter and Y set—Devices used for administration of two
or more infusates simultaneously. Access to the multiflow adapter is
usually via a cap that maintains sterility of the fluid pathway. Each
access of the adapter must be primed before attachment to the
administration system and prior to attachment to the infusion catheter
 Injection port or cap—Device used to gain access to the indwelling
catheter. Manufactured with resealable rubber caps, the device
permits access with either needles or needleless safety infusion
cannulas. Typically, they are lightweight and vary in length from 1/2
to 2 inches.

35.  The Q site is a injection-port device manufactured by B.D. It has
been found to be very effective in the reduction of catheter related
blood stream infections.
 The following are the steps to be followed when using the Q site for
a patient

36.  Mechanical Infusion Devices:
Mechanical infusion devices (MIDs) are devices that do
not require the use of an external power source to operate.
MIDs are relatively easy to use and monitor, but the nurse
should realize that they cannot detect flaws in the
administration system such as air in the set, infiltration, or
catheter occlusion.

37.  Elastomeric balloons are made of soft, expandable
material contained within a transparent hard plastic
casing. The prescribed medication is contained within
the balloon-like container. Microbore tubing is attached
to its outlet and, depending on its bore
size, delivers the fluid at a
corresponding rate over 30
minutes or more, depending
on the volume of the fluid

38.  Electronic infusion devices (EIDs) can be
divided into two categories, pumps and
controllers. The pump is a device that delivers its
solutions via positive pressure, whereas the
controller is a device that relies on gravity to
assist its action.

39. Positive Pressure Infusion Pump
 Pressure is expressed in pounds per square inch (psi). One psi is
equal to 50 mmHg. This pressure is exerted through the system
and culminates at the infusion catheter site within the patient. The
psi is an important consideration because it affects the integrity of
the entire system and is a factor when undue infusion pressures
cause a catheter to burst, an unfortunate and sometimes life-
threatening complication of infusion therapy

40.  Gravity initiated pressures usually average around 2 psi if the infusate
container is maintained approximately 60 cm (2 feet) above the
patient’s head. The higher the container, the greater the pressure
exerted.
 Pumps are used in high acuity care
areas such as critical care where the
therapies are complex. The pump
delivers infusate at an accurate prescribed
rate and has an alarm system that detects
infusion-related errors of delivery such as
free flow, air in the line, and changes in
vascular resistance such as occlusion or infiltration.

41.  It is one that calculates the infusion
volume delivered by the amount
displaced in a reservoir. Drop sensors
can also be included in this pump
category. The sensor may be located
internally in the pump where the fluid
passes through a chamber, but it is
usually found externally attached to
the drip chamber.

42.  Air in the line
 Occlusion
 Infusion complete
 Free flow
Patient controlled
analgesia (PCA) pumps are
available in ambulatory,
semiportable. The PCA pump
is capable of delivering
medication continuously or on
patient or clinician demand

43. Multichannel and dual-channel pumps
are pole-mounted EIDs that can be operated
by manufactured housing or channels within
a single device. Each channel can be operated
independently of each other. Different
medications and solutions can be
programmed for delivery at the same time.