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

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

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

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

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

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

CVC Line Occlusion Line won’t flush-STOP Notify MD

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

Post CVC Line Removal Assess site Pressure dressing Assess CVC cath Document

Complications of CVC Lines Sepsis Thrombus formation Air embolism