Central Venous Catheter Care Policy

Introduction

Central venous catheter (CVC) insertion is a complex procedure that has immediate and delayed complications. The ability to insert a ‘central line’ is an essential skill for many physicians and is performed by a range of specialities in a variety of locations. CVCs provide access when no peripheral veins are available and allow for administration of vasoactive, inotropic, hypertonic and irritant drugs that cannot be given peripherally. They are also required for access for extracorporeal blood circuits such as for renal replacement therapy and plasmapharesis; and for monitoring for example pulmonary artery pressure or central venous oxygen saturations and certain specialist interventions such as targeted temperature management and transvenous pacing. Despite the obvious benefits of CVC insertion more than 15% of patients will suffer a catheter related complication (McGee & Gould 2003).

The term central venous catheter (CVC) refers to an intravenous catheter whose internal tip lies in a large central vein. There are various different types of CVC but common to all is the idea that the tip of the catheter floats freely within the bloodstream in a large vein for example the superior vena cava at the junction of the right atrium, the inferior vena cava or the common femoral or external iliac veins.

Purpose

The purpose of this policy is to provide evidence based guidelines for the insertion and care of central venous catheters (CVCs) and to ensure that a consistent standard of practice exists across the trust in order to minimise complications from insertion and reduce catheter related blood stream infections (CRBSIs).

Policy Details