suprasternal notch. The direction of the needle is now aligned with the central axis of the SCV, minimizing the risk of puncturing the subclavian artery, pleura, or apex of the lung [46]. By keeping the needle in a horizontal plane, the risk of arterial or pleural injury is minimized [47]. On its course the needle goes through skin, superficial fascia, subclavius, clavipectoral fascia, and SCV. Correct Placement of Catheter Tip The catheter tip should be placed 3–4 cm above the junction of the…
common outcome for individuals who have a central line catheter. A catheter-associated bloodstream infection is very serious, but most of the time is can be treated successfully with antibiotics. It is known that bloodstream infections cost healthcare systems millions of dollars and results in thousands of patient deaths each year, yet most of these infections are preventable. The Institute of Medicine (IOM) published a report in 2000 and noted that a central line-associated bloodstream…
Central venous access devises (CVADs) are very important in healthcare practice. There are many issues related to patient’s safety concerning the use of CVADs in a hospital setting. Catheter occlusion is a substantial impediment to delivery of care. It occurs at a rate ranging between 3% and 79% and is responsible for many negative outcomes such as drug extravasation, loss of patency, device replacement, device removal and hospital visits. These negative outcomes may delay treatment process,…
Life long learning from a rare complication during subclavian venous cannulation Abstract- Placement of central venous cannulation (CVC) is generally a safe procedure but several complications like pneumothorax, arrhythmias, arterial puncture, infection and thrombosis may occur even in the experienced hands. Complications related to guide wire insertion or removal are very rare and mostly relate to expertise and knowledge of operating person. So here we report a rare but completely avoidable…
The identifying problem is Decreasing Central Line Bloodstream Infections in the Acute Care Setting by the Use of Multimodal Disinfectant Protocols. Collaboration was initiated with the assistance of the Hospital Chairperson of the Practice Council to initiate change in practice. Central Line Associated Bloodstream Infections (CLASBI) can result in financial burden and/or morbidity in the acute care setting. The financial burden associated with treating Central Line Associated Bloodstream…
Standardizing central venous catheter care: hospital to home The guideline for Standardizing central venous catheter care: hospital to home was obtained from the National Guideline Clearinghouse. This guideline standardizes care of the central line to ensure continuity of care and decrease complications. Central line infection and thrombosis cause thousands of deaths each year and increases medical costs (CDC). Proper care of the central line utilizing antibacterial dressings, passive…
placement of a Central Venous Access Device. With proper technique and licensed staff placing a central venous access device, the risk for complications can be minimized. Champions for Central Line Care is a journal that explains “the team approach for reducing CLABSIs. (Reed, Brock, & Anderson, 2014, p. 40)” CLABSI can be defined as a Central Line-Associated Blood Stream Infection (Giddens, 2014, p. 469). These infections are generally seen within 48 hours after insertion of a central line.…
that prompts movement from having the least recommended dialysis access to one that is considered the most effective and efficient. The patient has a central line as an access. The clinic as it stands is not meeting the Centers for Medicare and Medicaid Services or CMS guideline (Compton, 2005) to replace her central venous catheter (CVC) or central line access within a ninety day period. If not contraindicated, a permanent access…
spread of bacteria from an unknown colony. The study observed that catheter dressings treated with chlorhexidine have a 52% reduction in bacterial infections as compared to other dressings treated with alcohol. Furthermore, this type of dressing is able to avoid colonization of the bacteria in infected areas by about 40% (Rickard & Ray-Barruel, 2009). Gilles and colleagues performed a Cochrane systematic review relating to central venous line dressings that was first published in 2003,…
define peripherally inserted catheters and central lines. After describing the basic concepts of what a peripherally inserted catheter and central line are; safety, teaching, and care of the lines will be educated throughout. Central Lines “A central venous catheter, also called a central line, is a long thin, flexible tube used to give medicines, fluids, nutrients, or blood products over a long period of time, usually several weeks or more.” (Buchman 2011, WebMD). Common uses for central…