Key points in the NICE Guidance
- The case for adopting SecurAcath for securing PICCs is supported by the evidence
- SecurAcath is associated with a low incidence of catheter-related complications
- SecurAcath should be considered for any PICC with an anticipated dwell of 15 days or more
- Cost modelling shows savings of £9 – £95 per patient compared to Statlock
- Annual cost savings to NHS in England estimated to be a minimum of £4.2 million
Infusion Therapy Standards of Practice, 9th Edition, 2024
Section 36 – Vascular Access Device Securement
- VADs are secured to prevent complications associated with VAD dislodgement and VAD motion at the insertion site.
- Methods used to secure the VAD do not interfere with the ability to routinely assess and monitor the access site or impede vascular circulation or delivery of the prescribed therapy.
Practice Recommendations include:
- Use a securement method in addition to the primary dressing, to stabilize and secure VADs. Inadequate securement can cause dislodgement and complications requiring premature removal
- Avoid use of sutures as they are not effective alternatives to a securement method
- Evaluate the potential for clinical and fiscal efficacy of SASS for PICCs and CVADs
- Single-center observational studies demonstrate SASS to be more effective than traditional sutures and ASD in preventing catheter failure
The Infusion Therapy Standards are a well-respected, evidence-based document that are rigorously reviewed every three years.
Vascular Access in Neonates and Children
Editors: Biasucci, Disma, Pittiruti
Publisher: Springer, 2022
This is a practical guide to pediatric vascular access. It covers how to use ultrasound appropriately, how to prevent and manage early and late complications, and how to correctly place the catheter tip using ECG or radiology. It includes all the most modern approaches and devices. In particular, the best approach for some specific populations is covered, including neonates and infants, complex patients, and children with cancer or renal failure requiring long term treatments.
The SIP (Safe Insertion of PICCs) protocol update: Eight strategies, incorporating Rapid Peripheral Vein Assessment (RaPeVA), to minimize complications associated with peripherally inserted central catheter
Brescia, et al. Journal of Vascular Access, April 2022
“Subcutaneously anchored securement is safer and more effective than skin-adhesive devices, and has been associated with lesser risk of infection, as it allows more complete skin antisepsis around the exit site during care and maintenance. In patient populations at high risk for catheter dislodgment (non-collaborative patients, diaphoresis, etc.) subcutaneous anchorage should always be preferred.”
The SIC protocol: A seven-step strategy to minimize complications potentially related to the insertion of centrally inserted central catheters
Brescia, et al. Journal of Vascular Access, July 2022
“Subcutaneously anchored securement is safer and more effective than skin-adhesive devices. It is also theoretically associated with less risk of infection, since it allows more complete skin antisepsis around the exit site”
The SIF protocol: A seven-step strategy to minimize complications potentially related to the insertion of femorally inserted central catheters
Brescia, et al. Journal of Vascular Access, August 2021
“Considering the high risk of dislodgment of FICCs, the authors recommend considering subcutaneous anchorage as the preferred option in medium- or long-term femoral access”
GAVeCeLT-WoCoVA Consensus on subcutaneously anchored securement devices for the securement of venous catheters: Current evidence and recommendations for future research
Pinelli, et al. Journal of Vascular Access, July 2020
- SAS (SecurAcath) is effective in reducing the risk of dislodgment when used for securing PICCs and other types of central VADs in adult patients as well as in children and neonates.
- SAS (SecurAcath) is associated with a low incidence of undesirable effects—most of them local and of low clinical relevance—which probably can be minimized by appropriate prevention and management.
Choice and management of vascular access in the context of COVID-19 outbreak in Italy: Recommendations from clinical practice
Vailati, et al. Journal of Vascular Access, November 2020
- SIAARTI (“Società Italiana di Anestesia, Analgesia, Rianimazione e Terapia Intensiva”) Research Group on Vascular Access has formulated some essential recommendations for the optimization of the selection, insertion, and maintenance of the vascular access devices
- As regards securement, since COVID-19 patients are often treated by repeated pronation cycles, we suggest adopting long-term securement strategies (i.e. subcutaneously anchored securement devices) for all central lines (PICC, CICC, and FICC), in order to prevent accidental dislocations or removals.sidering the high risk of dislodgment of FICCs, the authors recommend considering subcutaneous anchorage as the preferred option in medium- or long-term femoral access”