Vascular Access Device (VAD) Passport

Vascular Access Device (VAD) Passport

Please click on the link above to access an example of the passport that you will be given to complete with your clinical team.

Important contact details:-

For Haematology and Oncology patients please contact the
Chemotherapy help line: 01905 760158 Ext 30048
For OPAT patients please contact the IV Therapy team on
01905681039 or your Neighbourhood team on 03007906253 and
select the option for your NT.

This Venous Access Device (VAD) passport
This passport has been designed to be kept with you, so that you receive consistent provision of best quality care regarding your VAD.

As a patient you are requested to present it to all clinicians that access
the device, both within ANY Acute hospital and the community that you
attend.

Introduction
VADs are long thin flexible tubes that are either inserted into one of the
large veins of the arm above the elbow or near your collar bone. The line
is then threaded into the vein and checks will be completed to ensure
that the line is in the right place.

The VAD is usually sealed with a special cap or bung. This can be
attached to a drip or syringe containing your therapy. There may be a
clamp to keep the line closed when it’s not being used. Sometimes the
VAD line will divide into 2 or 3 and this allows you to have different
treatments at the same time.

The exit site is cleaned, usually once a week and the line will be flushed
to stop it blocking. If you notice any swelling, pain, or fluid from the exit
site, or if you don’t feel well seek medical advice immediately and state
you have a VAD in place.

Types of VADS

Midline

This is a line that is inserted into a peripheral vein. This is ideal for patients who require 4-6 weeks of intravenous therapy.

Peripherally Inserted Central Catheter (PICC)
A PICC is inserted into a vein in the upper arm with the tip placed in a central vein.
They are inserted for patients that require > 6 weeks but
usually < 6-month therapy.

Tunnelled Central Venous Catheter (Hickman Line)

A Hickman line is threaded into a large vein with one end in the vein and
the other tunnelled under the skin where it comes out of the body. They
are inserted for patients that require > 6-month therapy.

Implantable Ports

An implanted port is a device, often referred to as a Port-a-cath®. They
are suitable for patients that require > 6-month therapy.

Types of VADS

After care

How do I care for the Midline/PICC?

The dressing will only need to be changed once a week. When you leave
hospital this can be performed in the community or when you attend
hospital appointments.

You should have a shower, bath or all over wash every day to keep your
skin generally clean. The transparent dressing over the exit site is shower
proof; however, take care not to get the PICC or extension set wet. The
dressing must remain clean, dry and stuck firmly to your skin.

During the first week after your catheter has been inserted, the PICC site
may be red and inflamed.

How do I care for the Hickman?

You will need to change the dressings after the first 24 hours and then
once a week using a semipermeable transparent dressing (this allows the
skin to breathe). Try to keep the dressing dry and intact. You should have
a shower, bath or all over wash every day to keep your skin clean.

How do I care for the port?

There is no special care needed for a port. The needle is removed in
between treatments and you will not have to worry about any dressings or
flushing the port.

Line flushes

Lines need to be flushed weekly with normal saline fluid to maintain
patency when they are not being used. To minimise the risk of infection,
the nurse will create a sterile environment around your line during each
line flush.

Removal of VAD:

VADs should be removed at the earliest opportunity when they are no
longer required.

The removal is dependant on the type of VAD you have and your medical
team will inform you when this is required.

The removal of the a PICC and Midline is a simple procedure, similar to
having a cannula removed. The dressing is removed and the PICC is
gently pulled out of the vein. A dressing will then be applied to the site
and can be removed after 24 hours.

The removal of a Hickman line and implanted port is a day case
procedure that requires local anaesthetic procedure, and stiches. More
information about your procedure will be provided by your medical team.

In what circumstances should I contact the hospital?
Although you should not expect to experience complications with your line,
there are some problems you may encounter.

Signal or symptom	Likely Cause	Action
Fever, chills, excessive pain, redness, swelling, warmth, drainage at insertion site.	Infection .	Based on severity of symptoms, IMMEDIATELY call the team who is caring for your device or, if you are not able to speak to them at that time, call 111/999.
Leaking or bleeding from line.	Break in the line or cap has come off.	If you are able to, clamp or kink the line above the damaged site and tape securely. Replace any missing caps. Call team caring for your device IMMEDIATELY. If no response seek medical advice (consider A&E) or contact 111.
Swelling around arm or neck.	Thrombosis (blood clot in vein).	Call your nurse or doctor IMMEDIATELY. A blood clot may have formed in the vein and around the line. Your doctor may infuse a drug to dissolve the clot or remove the line.
Blood is dripping from the hub area of the line.	Needleless connector cap has been disconnected accidentally	Call the team caring for device IMMEDIATELY. Replace needleless connector cap with a new one, if able.
Resistance is met when in- fusing drugs into the line.	Occluded (blocked) line.	Stop infusion and call the team caring for your device. Forcing infusion into an obstructed line can damage it. This may occur when a line has a blood clot inside it or at its tip, preventing fluid from passing. Your doctor may infuse a drug to dissolve the clot, or remove the line.
Change in external length of the line.	Line migration.	Do not push your line back in. Cover site with gauze and secure with tape. Call the team caring for device immediately. If unable to speak to them, call 111.
Whooshing sound in ear. Discomfort in the jaw, ear or face.	Line may have moved position.	Stop medication and call the team caring for device immediately. If unable to speak to them, call 111 or consider A&E.

For Haematology and Oncology patients please contact the Chemotherapy help line on 01905
760158 Ext 30048, first before calling 111 or going to A&E

The link to the VAD passport (see blue link at the top of this page) will also contain details about the dressing changes that will be completed by a clinician.

If your symptoms or condition worsens, or if you are concerned about anything,
please call your GP, 111, or 999.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you
and your loved ones. If you have any questions or concerns, please do speak with a
member of staff on the ward or in the relevant department who will do their best to
answer your questions and reassure you.

Feedback
Feedback is really important and useful to us – it can tell us where we are working well
and where improvements can be made. There are lots of ways you can share your
experience with us including completing our Friends and Family Test – cards are
available and can be posted on all wards, departments and clinics at our hospitals. We
value your comments and feedback and thank you for taking the time to share this with
us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the
nurse in charge or the department manager in the first instance as they are best
placed to answer any questions or resolve concerns quickly. If the relevant member of
staff is unable to help resolve your concern, you can contact the PALS Team. We offer
informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf,
if you feel unable to do so, to resolve your problems and where appropriate refer to
outside help.

If you are still unhappy you can contact the Complaints Department, who can
investigate your concerns. You can make a complaint orally, electronically or in writing
and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Thursday from 8.30am to 4.30pm and
Friday: 8.30am to 4.00pm. Please be aware that a voicemail service is in use at busy
times, but messages will be returned as quickly as possible.

If you are unable to understand this leaflet, please communicate with a member of
staff.

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