Vascular Access

Central venous access devices (CVADs) are a mainstay for many patients receiving mid-to-long-term intravenous therapy. Cancer Institute of NSW programs, eviQ and eviQ Education, provide free online cancer treatment protocols and resources for clinicians, patients and carers. In 2021, the complete suite of eviQ CVAD resources were updated via extensive consultation with vascular access experts and the evidence-based literature to reflect the latest evidence for CVAD management. Resources include eLearning modules, clinical procedures, complication management algorithms, assessment and documentation tools, quizzes, and patient education materials. We encourage readers to explore and promote eviQ and eviQ Education for CVADs and share these resources with nursing, interventional radiology, or medical colleagues caring for patients with a CVAD, as well as patients and carers.

Introduction Haemorrhage is the leading cause of preventable death in combat settings. Pre-hospital practice guidelines advocate for the rapid delivery of blood products and intravenous access to deliver adjunct treatments. However, peripheral intravenous catheter (PIVC) insertion is challenging in the austere setting, and catheter failure is common. This study aims to investigate dressing and securement methods to prevent catheter dislodgement and explore participants’ experiences with these methods within an Australian Defence Force Tactical Combat Casualty Care (TCCC) training course.

Methods and analysis A two-phase mixed-method design will be used to compare the Ruggedised Field (Ranger) method with the S‑Wrap technique to reduce PIVC dislodgement rates during TCCC simulations. The study will be undertaken at the Australian Army School of Health in Victoria, Australia. In Phase 1, we will examine the pull-out force of each dressing securement method in vitro. Phase 2 will involve (i) an observational audit (n=30 participants) of TCCC training to assess the quality and safety of PIVC securement practices and (ii) focus groups with participating healthcare professionals (HCPs) (n<15 participants) to understand their lived experiences of PIVC insertion and securement practices. Associations between pull-out forces will be assessed using analysis of variance, and descriptive statistics will be used to summarise audit data. Focus group data will be analysed using content analysis.