Central Lines CVC-Central Venous Catheters

1. Central LinesCVC-Central Venous Catheters The placement of a catheter in the right superior vena cava via the cephalic or basilic veins.

2. Purpose of Central Lines • Poor peripheral venous access • Administer large volumes & multiple IVF’s • Central lines may have 1-4 ports • Administration of “caustic” meds • Long term administration • Diagnostic/blood sampling • TPN solutions

3. Anatomy of a Central Line • Usually made of silicone • Has 1-4 ports with male adaptors • “Surgically” inserted by MD • Sutured into the skin to prevent dislodgement • Covered with sterile dressing

4. Nursing Responsibilities • Verify patient’s consent/allergies • Secure supplies-can be performed @ bedside • Prepare IVF per MD orders or heparin flush • Wash insertion site prior to insertion • Patient education

5. CVC Maintenance/Care • Know facility policy • CVC dressing change • Assess for redness, warmth, edema, drainage • Use transparent dressing • CVC site care • Do not touch insertion site • Use CVC dressing kit if available

6. Flushing CVC line • Essential in maintaining patency • Never use a syringe with < 10 mL-creates to much pressure • Saline 10-20 mL • Heparin (100units/mL) 5 mL-have patient perform Valsalva manuever (prevents occulsion of line) • Change male adaptors per policy

7. CVC Line Occlusion • Line won’t flush-STOP • Notify MD

8. Removal of CVC Line • RN can remove CVC line • Review procedure per facility policy • Position patient in Trendelenberg or flat • Hand hygiene • Remove dressing/sutures • Valsalva maneuver (prevents air embolism) • Pull with smooth steady motion

9. Post CVC Line Removal • Assess site • Pressure dressing • Assess CVC cath • Document

10. Complications of CVC Lines • Sepsis • Thrombus formation • Air embolism