Central Lines
 

Troubleshooting During Insertion

 
 
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Overview

  • No flashback (not in the vein) - try advancing further or pulling back and inserting slightly medially or laterally
  • Flashback but no blood coming out (penetrated too far) - pull back slightly, adjust the angle of the needle against the skin, pull back and try again
  • Bright red blood that is pulsating out (arterial sample) - remove the needle and apply pressure for at least 3 minutes
  • Haematoma - remove the needle and apply pressure to the area.
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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