The first Summit Forum on Vascular Access Nursing was held in Cancer Hospital of Fudan University on October 16, 2015, coinciding with the 10th anniversary of the establishment of the Vascular Access Clinic of Cancer Hospital. During the forum, Nurse Manager Xi Yan of Pancreatic Surgery Department made a case study report on CVC extubation respiratory distress syndrome, and elaborated her views and clinical insights on CVC intravenous access nursing for patients with advanced chemotherapy of pancreatic cancer. Nurse Xi Yan is the head nurse of pancreatic surgery of Fudan University Cancer Hospital, the head of IV-team CVC team of Fudan University Cancer Hospital, and the national champion of the first “Methodology Cup”. As the leader of the pancreatic surgery nursing team, Nurse Manager Xi Yan has rich clinical practice experience in pancreatic cancer clinical nursing, especially in CVC intravenous access nursing, and has established a good reputation among patients. In recent years, she has done a lot of work in creating quality nursing services. In terms of nursing management, quality control of high-risk links has been strengthened, and six special safety management groups have been established for catheter-related bloodstream infections, blood glucose monitoring and management, accidental decannulation, pressure sores, falls, etc., to analyze the root causes of adverse events that occur. Central venous catheter access care for pancreatic cancer patients CVC (central venous catheter) is a common intravenous access for surgical procedures. CVC can be used for large and rapid intravenous infusion, and is often found in procedures where blood loss may be large, such as pancreatic-related surgery. PICC (peripherally inserted central catheter), is used for pancreatic cancer chemotherapy patients, these patients take intravenous chemotherapy for a long time, vascular conditions are often poor, and many chemotherapeutic drugs such as paclitaxel-like, fluorouracil and other chemotherapeutic drugs with strong irritation to the intima, have strong local toxic reactions, peripheral venous drug use is prone to phlebitis, and PICC avoids these problems. Due to the widespread use of central venous catheters in pancreatic cancer patients, effective care of central venous catheter access for pancreatic cancer patients is crucial to their recovery. Several points of attention for CVC venous access nursing: 1. Routine assessment and maintenance: nurses regularly observe and assess the condition of the catheter placement site, such as: local bleeding, oozing, redness and swelling at the puncture point, film rolled edges, etc. They will do timely maintenance of the catheter; routine weekly maintenance. 2, catheter fixation: to reduce the incidence of central venous catheter infection should avoid the use of sutures to fix the catheter, it is appropriate to use a suture-free fixation device to fix the catheter (recommended by the 2011 edition of INS Infusion Guidelines), fixed catheter dressing should be selected directly greater than 10 × 250px transparent dressing, to the puncture point as the center of the catheter to do a good job of decompression fixed to avoid skin tension blisters or catheter pressure for a long time to cause acute pressure sores occur. 3, prevention of catheter blockage: after the infusion of blood products, hypertonic, viscous fluids need to use 20ml saline pulse flush tube (gravity infusion can not replace the pulse flush tube). Follow A-C-L catheter maintenance best practice to draw back blood before flushing to determine the function of the catheter (Assess), pulse flush with saline (Clear), and seal the catheter with 2 times the volume of the catheter plus extension tube with 0-10u/ml sodium heparin saline under positive pressure after flushing (Lock). When the catheter is blocked, the cause of blockage should be analyzed and saline should not be forcibly pushed. 4. Prevention of catheter-related bloodstream infection (CRBSI): the maximum sterile barrier should be ensured when placing the catheter; the catheter should be disconnected in time when no use value is assessed; the choice of disinfectant solution for catheter maintenance should be 2% chlorhexidine gluconate ethanol solution, and sufficient time, area and friction should be ensured for disinfection during maintenance; aseptic operation should be strictly implemented during infusion, and if a blood clot is found in the infusion connector, it should be If blood clot is found in the infusion connector, it should be replaced in a timely manner; the non-closed infusion device should be replaced every 24 hours; the dressing should be changed in a timely manner when there is obvious blood ooze or sweat stains at the puncture site; if CRBSI is suspected, the infusion should be stopped immediately, and the catheter should be temporarily kept for medical advice to extract blood culture and wait for the results and further treatment (recommended in the “2013 Technical Practice of Intravenous Therapy Care in China”). 5, catheter removal: when removing the catheter, the patient should adopt the reclining position with the pillow removed; during the catheter removal, the patient should be asked to do the Valsalva action (hold the breath for 10 seconds and then exhale); after the catheter removal, it is appropriate to choose an oily dressing to close the venous notch, and the compression technique, appropriate compression force (0.4~0.8kg), appropriate compression time (15-30min) and sufficient lying down of the patient should be used to extend the vascular direction. A series of intensive care measures, such as extended compression technique, appropriate compression force (0~0.8kg), appropriate compression time (15-30min) and sufficient lying down time (15-30min), should be adopted to effectively avoid central venous catheter withdrawal distress syndrome.