Chronic venous access: bedside placement technique and complications

Long-term tunneled venous access catheters have evolved into safe and useful tools. More than 80% of these are implanted in patients in operating rooms with fluoroscopic and anesthesia support. This article describes a technique for safely placing these catheters at the patient's bedside and focuses on how to identify, prevent, and manage common complications associated with this procedure. This article also summarizes 8 years of the authors' personal experience with bedside placement and describes a hospital quality assurance study that evaluated the efficacy of bedside placement. The role of appropriately trained personnel is highlighted. The possibility of cost savings, totaling millions of dollars, is raised.