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Class Progress
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Chapter Listing

Current Practices in the Management of Central Lines



Definition of a Central Venous Access Device:

A device with many names: the central line, central venous catheter (CVC), central venous access device (CVAD) all refer to a catheter whose tip ends in the superior vena cava just above the heart.  Catheter tip placement in the SVC allows for rapid dilution of the infusate.  This rapid dilution decreases the risks of phlebitis and venous sclerosis.  In the case of femorally placed central lines, the tip will reside in the inferior vena cava. There are many brands and types of CVADs.  Each catheter type has distinct advantages and disadvantages.

There are many reasons a patient may have a need for a central venous catheter: 
  • Need for a large volume of fluid to be administered quickly as in the case of shock, or massive bleeding
  • Requirement for multiple intravenous medications or solutions
  • Allow central venous pressure (CVP) monitoring
  • Long term venous access requirements as with chronic diseases
  • Need for the infusion of vesicant medications
  • Need for medications that have an extreme pH. Medications with a pH of less than 5 or higher than 9 require a central line for infusion
  • Need for medications that have a high osmolarity.  Medications or solutions with an osmolarity of higher than 600 require a central line for infusion
  • Need for medications known to cause phlebitis if given via a peripheral vein


For the list of known phlebogenic medications and solutions recommended to be given via a central venous catheter CLICK HERE

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