Central Lines

Choosing the Right Site



    • Do

    • Think about the future plan for this patient, and whether this site will be needed for any other access
    • Don't

    • Don’t insert a needle through a burn, oedema or infected tissue
    • Don’t insert a CVC into an area with localised deformity, e.g. clavicular or femoral fracture
    • Don’t insert a subclavian CVC on the same side as a pacemaker
    • Don’t insert a subclavian CVC into a coagulopathic patient
    • Avoid a femoral CVC in a patient who is incontinent - especially of faeces
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 Bannon MP, Heller SF, Rivera M. Anatomic considerations for central venous cannulation. Risk Manag Healthc Policy. 2011;4:27-39. Czepizak CA, O’Callaghan JM, Venus B. Evaluation of formulas for optimal positioning of central venous catheters. Chest. 1995 Jun 30;107(6):1662-4.
Graham AS, Ozment C, Tegtmeyer K, Lai S, Braner DA. Central venous catheterization. N Engl J Med. 2007 May 24;356(21):e21.
 Vesely TM. Central venous catheter tip position: a continuing controversy. Journal of Vascular and Interventional Radiology. 2003 May 31;14(5):527-34.