The CDC definition of a central venous catheter, also known as a central line, is a tube that physicians place in a large vein in the neck, chest, groin, or arm to give fluids, blood, or medications or to do medical tests quickly. Central lines are much different from standard IVs used to give medicine into a vein near the skin’s surface, usually for a short period of time. Central lines are longer in size and are placed deeper in the body into a large blood vein. Central venous catheters are typically used for medical procedures such as blood pressure monitoring, blood sampling, and the administration of drugs and fluids to a patient.
The central venous catheter is advanced until the tip of the catheter resides within the superior vena cava, inferior vena cava, or right atrium. The puncture is preferred to be done on the right side of a patient’s body, to ensure the shortest and most direct course of the catheter to the right side of the heart. These insertion sites include the internal jugular, subclavian, or femoral vein. The femoral vein is used for a CVC when no other vessel remains puncturable; this is due to the high risk for infections in the groin area.
While the CVC is left indwelling in the vein, it should be soft and flexible to prevent erosion along the vein wall. These long, flexible, y-shaped catheters, instill medicine in a large vein to prevent complications allowing the catheter to give a patient the needed treatment. Central lines can be found in several settings: intensive care units, special care units, long-term care facilities, and outpatient facilities. Additionally, sometimes a patient can have a central venous catheter while at home after a hospital visit or long-term treatment.
Tips for Caring for Your Central Venous Catheter
Responsibility for the daily care of long-term central lines is often delegated to patients and their caregivers. Routine inspection of a central line, regardless of the location, should be performed daily. The more attention to detail will reduce the likelihood of a device related complication.
Using gloves, the semipermeable dressings should be removed weekly or sooner if it is damp, loose, or no longer visibly intact. Before replacing the dressing, wash your hands with soap and water.
To reduce the risk of line infection, patients are advised to shower and not bathe (or any submerging in water). Vigorous physical activity should be avoided, for involving the line will be completely involving the upper body and may cause the line to be displaced.
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Practice guidelines for central Venous Access 2020. An updated report by the American Society of Anesthesiologists Task force on central Venous Access. (2020, January 01). https://pubs.asahq.org/anesthesiology/article/132/1/8/108838/Practice-Guidelines-for-Central-Venous-Access