An integrated peripheral intravenous (IV) catheter configured for blood draw both at the time of catheter placement and during catheter indwell. The peripheral IV catheter includes a catheter adapter having a catheter configured to be inserted into a patient's vasculature and a side inlet defining a fluid pathway into and out of the catheter. The peripheral IV catheter also includes a side port member having a main branch, the main branch including a distal end configured to couple the side port member to the side inlet of the catheter adapter and a connector portion accessible via a proximal end of the main branch. Additionally, the peripheral IV catheter includes a blood collection adapter removably and directly coupled to the connector portion of the side port member at the proximal end of the main branch. Furthermore, side pore member of the peripheral IV catheter may include a side branch.

An instrument advancement device may include a housing, which may include a slot. The instrument advancement device may be configured to couple to a catheter assembly. The instrument advancement device may include an advancement element, which may extend through the slot and may be configured to move linearly along the slot between a retracted position and an advanced position. In response to movement of the advancement element from a retracted position to an advanced position, an instrument of the instrument advancement device may be advanced beyond a distal end of the housing and may be configured to open a path through an occlusion in the catheter assembly or vasculature. The instrument advancement device may include a septum that includes a shape and/or a lube to reduce septum resistance and buckling of the instrument during advancement of the instrument.

A catheter system may include a catheter adapter, which may include a distal end and a proximal end aligned with the distal end. The catheter system may include a catheter extending from the distal end of the catheter adapter. The catheter system may include an extension set, which may include a distal end, which may include a first connector coupled to the proximal end of the catheter adapter. The extension set may include a second connector and an extension tube disposed between the first connector and the second connector. The catheter, the catheter adapter, the first connector, the extension tube, and the second connector may be in fluid communication. The catheter system may include a stabilization platform disposed below the first connector.

A vascular access device may include a housing, which may include a distal end, a proximal end, and a slot. An advancement element may extend through the slot and may be configured to move linearly along the slot between a retracted position and an advanced position. In response to movement of the advancement element from the retracted position to the advanced position, a probe of the vascular access device may be advanced beyond the distal end. The vascular access device may include one or more features to reduce buckling of the probe and limit displacement of the probe. For example, the vascular access device may include a protrusion fixed within the housing distal to the advancement element. As another example, the vascular access device may include a distally-extending arm and/or a recess configured to receive the distally extending arm.

An instrument advancement device may include a housing, which may include a distal end and a proximal end. An instrument, such as a vascular access instrument configured to enter vasculature of a patient, may be disposed within the housing. The instrument advancement device may include an advancement element. In response to movement of the advancement element with respect to the housing, the instrument may be configured to advance distal to the distal end of the housing. The housing or a distal end of the housing may include a compressible portion proximate a chamber configured to hold blood. In response to compression of the compressible portion, the housing may be configured to dispense blood distally from the chamber through the distal end of the housing.

A vascular access system can have a probe with a dynamically expandable distal end. The dynamically expandable probe can be inserted through a catheter while the catheter is positioned intravenously to facilitate fluid flow into or out from the catheter such as by moving an occlusion away from the catheter tip, removing an occlusion, accessing additional sources of blood and/or repositioning the catheter tip. Because it is dynamically expandable, the probe can minimize the likelihood that it will become occluded while it is inserted intravenously and may provide control over the rate of fluid flow into or out from the catheter.

An instrument delivery device may include a housing, which may include a proximal end, a distal end, and a slot. The instrument delivery device may include an advancement element extending through the slot and configured to move linearly along the slot. The instrument delivery device may include a guidewire, which may include a first end and a second end. In response to movement of the advancement element distally a first distance along the slot, the second end of the guidewire may be configured to advance a second distance. The second distance may be at least twice the first distance. The instrument delivery device may include a tubing, which may include a distal end and a proximal end. In response to movement of the advancement element distally the first distance along the slot, the proximal end of the tubing may be configured to advance the first distance.

A catheter assembly may include an adapter having a distal end, a proximal end, a side port, and an adapter lumen. The catheter assembly may include a catheter hub, which may include a distal end, a proximal end, a catheter hub lumen, and another side port. The catheter assembly may include an extension tube. A distal end of the extension tube may be coupled to the other side port, and the distal end of the adapter may be coupled to a proximal end of the extension tube. A fluidic seal may be formed around a tube of an instrument advancement device when the tube is advanced into the adapter. As an example, a portion of the adapter lumen between the distal end of the adapter and the side port may include an annular protrusion configured to form the fluidic seal.

A vascular access device may include an advancement element and a housing. The housing may include a lumen extending therethrough, which may be used for blood collection. The vascular access device may include a pair of opposing pinch members configured to pinch the housing. The pair of opposing pinch members may be configured to move along the housing with the advancement element. The vascular access device may include a guidewire, which may include a wedge. In response to moving the advancement element distally along the housing, the pair of opposing pinch members may move the wedge distally and the guidewire may be advanced distally. The proximal end of the guidewire may include a looped portion, and in response to moving the advancement element distally along the housing, the pair of opposing pinch members may be aligned with an opening formed by the looped portion and advance the guidewire distally.

Apparatus for passing a blocked vein, including: (a) an intravascular catheter body defining at least one lumen; (b) a radially expandable anchor at a distal end of said catheter; and (c) a penetration tool sized and shaped to be delivered by the lumen to a point distal of the expandable anchor, the penetration tool including a tip and configured for being pushed through venous blockage more than one week old and present with a young's modulus greater than 1 MPa. Optionally, the penetration tool tip comprises a sharpened tip. Optionally or additionally, the penetration tool tip is controllably bendable.