Central Venous Catheter (CVC) Procedure

A central venous catheter (CVC), also known as a central line, is a type of catheter that is inserted into a large vein in the neck, chest, or arm to deliver medication, fluids, or nutrients over a long period. The procedure involves inserting a thin, flexible tube into a central vein, which allows for direct access to the bloodstream.

Indications

• Administration of chemotherapy or other medications that are irritating to peripheral veins
• Delivery of total parenteral nutrition (TPN) or other nutrients
• Monitoring of central venous pressure (CVP)
• Administration of blood products or fluids in emergency situations
• Dialysis access for patients with end-stage renal disease

Types of Central Venous Catheters

• Tunneled catheter: inserted under the skin and secured with a cuff to prevent infection
• Non-tunneled catheter: inserted through a needle and secured with sutures or tape
• Peripherally inserted central catheter (PICC): inserted through a vein in the arm and guided to the central vein
• Implantable port: a small device implanted under the skin that allows for access to the central vein

Insertion Procedure

The insertion procedure typically involves the following steps:

1. Preparation of the patient, including cleaning and draping the skin
2. Administration of local anesthesia to numb the area
3. Insertion of a needle into the vein under ultrasound or fluoroscopic guidance
4. Threaded a guidewire through the needle and into the vein
5. Passed the catheter over the guidewire and into the vein
6. Secured the catheter with sutures, tape, or a cuff

Risks and Complications

• Infection: risk of bacterial colonization and bloodstream infection
• Bleeding or hematoma at the insertion site
• Pneumothorax (collapsed lung) or hemothorax (bleeding in the chest cavity)
• Thrombosis or blood clots in the vein
• Catheter malfunction or occlusion

Post-Insertion Care

After insertion, the catheter requires regular maintenance to prevent complications, including:

• Flushing with saline solution to maintain patency
• Cleaning and dressing the insertion site to prevent infection
• Monitoring for signs of infection or other complications

Removal Procedure

The removal procedure typically involves the following steps:

1. Preparation of the patient, including cleaning and draping the skin
2. Administration of local anesthesia to numb the area
3. Removal of any sutures or securement devices
4. Gently pulling out the catheter
5. Applying pressure to the insertion site to prevent bleeding