Central Line Insertion

Coagulopathy, localised deformity

E.g. procedure pack with gauze, cotton balls etc.

For jugular and femoral insertion

With sterile ultrasound probe cover and gel

Chlorhexidine

Large drape to cover the entire patient

With needle, guidewire, dilator and CVC

For each lumen of the CVC

For insertion and flushing lines

For local anaesthetic

To flush lumens

1% lignocaine

Suture material, scissors, forceps

Sterile, transparent occlusive dressing

Bin and sharps disposal close by

Open all required sterile equipment onto field

Decontaminate a large area with chlorhexidine

Expose the decontaminated site and cover everything else

Draw up local, place everything in the order it will be used

Place bungs on all lumens except central lumen, flush each lumen

Create a small wheal over the insertion site

While holding onto guidewire, apply pressure to site using gauze

Using the scalpel, make a small incision adjacent to the guidewire

While holding the guidewire, insert dilator just into the vein and then remove it, placing pressure with gauze

Fix in place at one or two points

Using sterile, transparent occlusive dressing

Internal jugular and subclavian catheters

Using chest x-ray

Most commonly with subclavian catheters