Central line placement is indicated in patients who need hemodynamic monitoring, rapid volume resuscitation, therapies such as vasopressors, central parenteral nutrition and vesicant infusions and in patients with difficult venous access.  The central line course will teach clinicians how to place subclavian lines, internal jugular lines and femoral lines using advanced simulation manikins.  Our training in central line insertion covers central venous access indications, contraindications, preparation, technique, complications and their management.  Techniques for triple lumen, cordis and hemodialysis catheter placement will be taught.  The course will cover both landmark-based central line placement and ultrasound-guided central line insertion for internal jugular lines, subclavian lines and femoral lines. The course emphasizes ultrasound-guided vascular access

The HPC Hospitalist and Emergency Procedures course will teach you how to perform central line placement in addition to endotracheal intubation, stylet-guided intubations, laryngeal mask airway (LMA) placement, King tube placement, or fiberoptic intubations. ultrasound-guided peripheral IV access, arterial lines, POCUS exams (RUSH exams and E-FAST exams), thoracentesis, paracentesis, lumbar punctures, chest tube placement, pigtail catheter placement, needle thoracostomy, procedural sedation, and ventilator management.

Our central line placement training is a component of our live Hospitalist and Emergency Procedures CME course which teaches clinicians how to perform the 20 most essential procedures needed to work in the ER, ICU, and hospital wards.

CLICK HERE to find out more about our premier live Hospitalist and Emergency Procedures CME course

Central Line Placement Course trains students in:

• Indications for a central venous catheter placement
• Contraindications for central venous catheter placement
• Complications of central venous catheter placement
• Equipment for central venous catheter placement
• Proper positioning and technique for central venous catheter placement
• Central venous catheter troubleshooting
• Coding for central venous catheter placement

More information about Central Line Placement

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.

Complications Associated with Central Line Placement

The risks associated with central line placement are very similar to the risks associated with other similar or related procedures such as an internal jugular line placement. These risks include:

• Central line-associated bloodstream infections (CLABSI)
• Pneumothorax
• Artery injury
• Hematoma
• Deep venous thrombosis

Other uses for Central Line Placement

A central line catheter may be inserted if a patient has veins which are exceptionally difficult for medical personnel to access.

Central venous catheter may be placed in patients who are to receive ongoing chemotherapy.

Patients receiving therapeutic treatments such as blood or platelet transfusions.

What to do if you’re experiencing issues with a Central Line Catheter

If it’s an emergency and you’re not already admitted to a medical facility, then contact your local emergency dispatch, or go to the nearest ER or emergency medicine facility. For non-emergency issues, contact your primary care physician who will advise you of what to do.

Symptoms of infection may include swelling or pain around the insertion point or fever. In some cases a Central Line may cause a blood clot in the vein containing the line. This may be indicated by swelling or soreness, chest pain, chest tightness, or shortness of breath.

Ask an Hospital Procedures Consultant Physician

Our goal is to provide the best online resource for emergency medicine related ques/ons and concerns. If you’re interested in discussing Central Line Placement further, or you have a questions which isn’t answered here we invite you to ask the experts directly at www.Facebook.com/HospitalProcedures. We look forward to hearing from you.

Register HERE 21 days before the course to SAVE $50-150 and get the following:

1. 12 month online access to Online CME course, procedure video bundle, instructional posters
2. Indefinite online access to PDFs of all course lectures, course handouts, and HPC Adult Critical Care and Emergency Drug Reference Drug