Central Venous Catheters are referred to as several different names such as CVC, Central Line, Vascular Access, etc... There are many different types of Central Catheters. Some are more or less central than others. The more or less centrally a catheter is depends on the distance from the superior vena cava. However, whether a PICC, Broviac, Subclavian or any other central catheters, they are all at risk for infection. Along with the different types of central lines, there are also internal and external lines. External lines are the typical lines that we use at the hospital for our average patients. Internal central venous access is more for the chemotherapy and hematology patients that are going to need very long term access.
The policy at Children's hospital is to be sterile when accessing any central line, this includes when changing tubing and Qsytes, placing medications on tubing that does not havea Qsyte intact, changing dressings and stringing any lines that are going to be placed on a central line.
The patient, family members or anyone else in the room should also wear a mask while the central line is being opened.
All dates on tubing and dressings should be easily visible.
Some reasons to place a central line in a patient would be the following:
poor peripheral venous access,
long-term antibiotics,
needed drugs that cause harm to most peripheral venous access,
frequent labs,
TPN-parenteral nutrition,
CVP monitoring,
long-term pain management
severe dehydration
There are several complications that can come from having central venous access.
The number one complication that the hospital is trying to decrease is
infection.
Others that are less common are air embolism and pneumothorax during insertion for lines placed through the chest.
Remember, if you see anyone breech the protocols when accessing central lines, stop them immediately and guide them through the correct process of accessing central lines.
Mishandling central access devices can lead to severe problems in our patients.
References
Seatle Treatment Education Project.
The Facts About Intravenous Catheter Lines. Retrieved on March 12, 2011 from The Body website at http://www.thebody.com/content/art1786.html
Putigna, F.& Solenberger, R.(2009). Pediatric Surgery for Central Access. Retrieved from Emedicine website http://emedicine.medscape.com/article/940865-overview