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Complications of vascular access devices.

With the aging of society and the ever-expanding tools of modern medicine, the emergency physician is likely to encounter an increasing number of patients with externally hanging or internally implanted vascular access devices. Aseptic technique, proper access, and appropriate heparinization will provide safe yet rapid vascular access with minimal patient discomfort or risk of complication. On the other hand, patients who present to the emergency department with these devices already functioning should cause the ED physician to add potential catheter and/or pump complications to his or her differential diagnosis when evaluating the patient. In the case of implantable devices containing metal, the physician should be aware that access to electromagnetic radiation devices will be prohibited unless a nonmetallic device is utilized. Historically, the presence of such devices should be documented to prevent erroneous interpretation of imaging studies.