Central Lines
Central Lines
 

Potential CVC Sites

 
 
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Internal Jugular Vein

    • Look

    • Between the two heads of the sternocleidomastoid muscle - ask the patient to turn their head.
    • Considerations

    • Use the right internal jugular vein where possible, due to its larger diameter and proximity to the superior vena cava.

Subclavian Vein

    • Considerations

    • Avoid in patients with clavicular fracture
    • Avoid in coagulopathic patients, as it is impossible to compress the artery if it is punctured
    • Avoid on the same side as a pacemaker

Femoral Vein

    • Considerations

    • Makes ambulation difficult
    • Preferred for coagulopathic patients, due to ability to compress the site
    • Higher risk of infection
    • Higher risk of thrombosis
Last updated on January 1st, 2018
 
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Baik SY, Kim EK, Hong SK. Strategies to prevent central line-associated bloodstream infections in intensive care units. Journal of Microbiology, Immunology and Infection. 2015 Apr 1;48(2):S75-6.
 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.
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