Central Lines CVC-Central Venous Catheters

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Central LinesCVC-Central Venous Catheters

• The placement of a catheter in the right superior
  vena cava via the cephalic or basilic veins.

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Purpose of Central Lines

• Poor peripheral venous access
• Administer large volumes multiple IVFs
• Central lines may have 1-4 ports
• Administration of caustic meds
• Long term administration
• Diagnostic/blood sampling
• TPN solutions

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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

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Nursing Responsibilities

• Verify patients consent/allergies
• Secure supplies-can be performed _at_ bedside
• Prepare IVF per MD orders or heparin flush
• Wash insertion site prior to insertion
• Patient education

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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

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Flushing CVC line

• Essential in maintaining patency
• Never use a syringe with lt 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

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CVC Line Occlusion

• Line wont flush-STOP
• Notify MD

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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

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Post CVC Line Removal

• Assess site
• Pressure dressing
• Assess CVC cath
• Document

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Complications of CVC Lines

• Sepsis
• Thrombus formation
• Air embolism