Peripheral Arterial Disease (PAD): A Comprehensive Overview

Peripheral Arterial Disease (PAD) is a condition that affects the arteries outside the heart and brain, primarily caused by atherosclerosis, leading to reduced blood flow to the limbs. Understanding PAD is crucial for effective management and treatment strategies. Here are some key points extracted from various vascular access guidelines and textbooks, including the Infusion Nurses Society (INS) 9th Edition 2024:

Glossary Insights:

  • Thrombophlebitis: Inflammation of the vein with the formation of a blood clot (thrombus).
  • Tissue adhesive (TA): Medical-grade cyanoacrylate glue that can seal the insertion site and bond the catheter to the skin.
  • Transducer: Device converting one form of energy to another.
  • Vascular access device (VAD): Device inserted into the vascular system, including veins, arteries, and bone marrow.

(Source: INS 9th Edition 2024, Page 277)

Vascular Access Device Postinsertion Care:

  • Remove excess hair at the insertion site using single patient-use scissors or disposable-head surgical clippers.
  • Perform skin antisepsis at VAD site, ensuring solutions dry per manufacturer’s instructions.
  • Assess and protect skin integrity at VAD site with each dressing change.
  • Consider the use of tissue adhesive for decreased dressing changes and increased survivability.
  • Choose the appropriate sterile dressing based on factors like VAD type, risk of bleeding/infection, and patient preferences.

(Source: INS 9th Edition 2024, Page 139)

  • Implement care bundles and a culture of safety to reduce VAD-related infections.
  • Assess patients with VADs for signs of infection and educate them about risks and interventions.
  • Evaluate site selection for VAD placement to reduce infection risks.
  • Perform skin antisepsis at the VAD site prior to placement and routine care.
  • Use chlorhexidine gluconate-containing dressings to prevent CLABSIs in patients with short-term CVADs.

(Source: INS 9th Edition 2024, Page 177)

Vascular Access Device Occlusion Management:

  • Assess VAD patency by flushing all catheter lumens without resistance.
  • Avoid incompatible mixing of IV solutions and medications.
  • Identify signs of VAD occlusion such as sluggish blood return, resistance to flush, and swelling at the infusion site.
  • Consider alternative actions if catheter patency cannot be confirmed, involving specialists and radiographic studies.

(Source: INS 9th Edition 2024, Page 172)