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Central Line


Overview & Description

A central line is a special intravenous line, called an IV. This type of IV is inserted through the chest and threaded into one of the large veins that lie close to the heart. A central line has multiple ports that can be used to:

  • draw blood
  • give fluids
  • monitor central venous blood pressure
  • Who is a candidate for the procedure?

    A central line is used for:

  • gaining emergency IV access when the usual IV access into an arm vein is not possible
  • monitoring central venous pressure during major surgery or after severe blood loss from trauma or illness
  • giving fluids, blood products, chemotherapy , and other medicines, as well as for hyperalimentation
  • drawing blood samples
  • administering long-term IV therapy
  • How is the procedure performed?

    A central line is inserted under sterile conditions. The person is usually placed in the Trendelenburg position, which means the head is below the level of the heart. The skin is cleansed, and a local anesthetic is injected to make the area numb. A healthcare professional advances the line until it reaches the large vein of the chest. The catheter is then sutured in place, and a sterile dressing is applied.


    Preparation & Expectations

    What happens right after the procedure?

    A chest X-ray will be done right away after a central line is inserted to confirm that it is in the right position. The line should not be used until the X-ray is done . A central line can usually stay in place for up to 4 weeks.


    Home Care and Complications

    What happens later at home?

    If the person is going home with the central line, the family will need to learn how to care for the catheter. A visiting nurse can come to the home to help the family with the care at first. The bandage at the insertion site will need to be changed every 3 days. The insertion site should also be inspected closely for signs of infection. These signs include redness, warmth, drainage, and swelling.

    What are the potential complications after the procedure?

    While inserting the line, it is possible to puncture the lung. The catheter may irritate the heart and cause irregular heartbeats, called arrhythmias. Other complications may include:

  • air embolism
  • bleeding
  • blood clot in the tubing
  • infection
  • Any of these complications may lead to the removal of the central line.


    Attribution

    Author:Pam Rosenthal, RN, BSN, CCM
    Date Written:
    Editor:Crist, Gayle P., MS, BA
    Edit Date:02/01/01
    Reviewer:Gail Hendrickson, RN, BS
    Date Reviewed:02/11/02

    Sources

    Illustrated Manual of Nursing Practice, 2nd Ed., 1994

    Textbook of Critical Care Nursing: Diagnosis and Management, Thelan, 1990


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