Clinical Procedure
 
Aliases:
Central venous line
CVL
Central line
CVAD
CVC
Central venous access
Central venous lines

Topic aliases are alternate phrasings for a particular topic.


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For administration of medications into a central vein that may otherwise cause irritation when infused into peripheral veins. Eg amiodarone, adrenaline, and noradrenaline.

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When placing internal jugular-cvc or subclavian vein-cvc in patients with lung pathology, place them on the side of the pathology to minimise the risk of pneumothorax in the normal lung #safety

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Sizing central lines for paediatric patients
Weight < 10 kg. 4 Fr
Weight 10-20. 4.5-5 Fr
Weight 20-50. 5 Fr
Weight > 50 7 Fr

#paedcvad

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How to straighten the curved tip of a guidewire with one hand if you need to put it back in a sheath.


From lifeinthefastlane.com/201...
"The guidewire actually consists of a coiled wire over a central wire core. Stabilizing the proximal part (with your palm and 3rd-5th fingers) allows your index finger and thumb to stretch the outer coil a bit which straightens the distal aspect of the wire.
Care must be taken not to hold the wire too tightly, which could cause the wire to kink and defeat the purpose of this trick."

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In infants and neonates, a 22g cannula may be preferable to the cannula supplied in the kit which is longer, more flexible, and more difficult to control.

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Depth of insertion for:

Right IJ (from puncture site 1) and Right SC (from puncture site 5)

If Height < 100cm then Initial Catheter Depth (cm) = (Ht (cm)/10) -1 cm

If Height > 100 cm then Initial Catheter Depth (cm) = (Ht (cm)/10) -2 cm

These formulas will place 98% of catheters above R atrium.

www.anesthesia-analgesia....

#paedcvad

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ANZICS Central Line Insertion & Maintenance Guideline
www.anzics.com.au/downloa...

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Royal Children's Hospital Melbourne Clinical Practice Guideline
www.rch.org.au/rchcpg/hos...

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If the window in plastic drape is too small for placement of a large tegaderm, cover the CVC at the insertion point with a small tegaderm to keep it sterile while removing drape, then place large tegaderm over the top.
#pic

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