Fast Facts for Central Lines It is IMPERATIVE for aseptic technique to be practiced at ALL times during care and

and use of all central lines (including PICC lines). Consent forms must be signed by patient or legal designees prior to insertion Insertion of central line: o When assisting physician with insertion of central line- have a 10 ml of NS for each lumen on the central line (i.e. if it is a triple lumen catheter have three 10 ml syringes of NS ready). o Physician will verify blood return from each lumen o Flush each lumen with the 10 ml NS syringe Drawing blood from a central line: o All infusions must be put briefly on hold o If the lumen you are drawing blood from is in use, you have to flush the line with 10 ml of NS prior to drawing blood o Then you must draw 10ml of blood and discard this blood as waste. o After you discard the 10ml of waste blood, draw the blood that will be used for the laboratory test. o Remember to flush the line again after drawing your blood with an additional 10ml. o Restart infusions (if lumen was being used prior to drawing blood) *** NEVER expose lumen opening to open air. Remember the end of the line is in the heart. The lumen must be clamped before disconnecting any IV tubing or syringe in order to avoid complications (air embolus).

Fast Facts for Central Lines

Dressing Care o Wear mask and sterile gloves to avoid contamination o If transparent tegaderm dressing is used, dressing must be changed every 72 hours and prn

o If a gauze dressing is used, dressing must be changed every 24 hours and prn Central line Flush: o Flush each lumen of central line every 12 hours to keep catheter to keep lumens from occluding if not being used for a continuous infusion and to keep the clean. o Flush lumen with 10 ml of NS before and after administration of any medication (IV fluid, blood, TPN, medication) or after drawing blood. Procedure to flush central line: o Supplies: alcohol prep, clean gloves, 10 ml syringe (exerts less pressure on catheter), three 10 ml syringes of NS o Wash hands, put on gloves, clean catheter port off with alcohol prep, connect syringe, inject NS into line, use positive pressure to prevent backflow and clotting. o Do NOT force NS into lumen if resistance is met, while attempting to flush the port, Discontinue flush o Documentation: Document date, time, solution utilized to flush line, how patient tolerated procedure

Fast Facts for Central Lines

Critical Thinking Scenario: When removing catheter cap to access line, what should you do with the cap? A. B. C. D. Hold cap in hand Place cap on bedside table with open end up Discard Place on sterile field

Answer: D Remember if you are not sure if the cap is sterile or not, throw it away and obtain a new cap. However, if sterility is maintained by placing the cap on the sterile field, it is not necessary to replace cap.

Fast Facts for Central Lines