A central line is a special form of a catheter, or tube, which emergency or other medical personnel may need to insert into a large vein in order to complete a variety of medical procedures. The central line procedure and device are referred to in many different ways, sometimes referred to as a central line, Hickman line, or central venous catheter, among other reference terms. A physican may choose to utlize a central line because it can handle a higher volume of fluids, extract blood with greater ease, and can remain inserted longer than a standard peripheral intraveneous line.
The basic concept is that a tube is inserted through the skin and into a deep vein. The exposed portion of the tube contains multiple IV ports that are capped. When accessed, the ports provide medical personnel with direct access to the vein, allowing for administration of fluid, emergency medications, hyperosmolar solutions (e.g., TPN) and can be used as access for insertion of devices such as pulmonary artery catheters or temporary transvenous pacemakers. When closed, the cap forms an airtight seal which prevents germs or dirt from entering the tube and causing infection or an air embolus.
With a procedure as invasive as a central line, infection is one of the worst complications that can occur. Not only from germs entering through the tube itself, but also from around the point of insertion. As a result, the insertion area needs to be meticulously cleaned and cared for. Other complications of central line placement include deep venous thrombosis, pneumothorax (for subclavian lines and internal jugular lines), hemothorax (for subclavian lines), hematomas and inadvertent cannulation of arteries.