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Line insertion

This must be carried out under full aseptic conditions. When carried out as an elective procedure, it should be undertaken in theater. If a line has to be re-inserted into a high-risk patient, particularly with line associated bacteraemia recently, prophylactic antibiotics may be indicated.

Requests for central venous catheter insertion should be discussed and arranged with the relevant personnel early in the day. CVP line usually inserted in theater by anaesthetist - you need to put patients' name on the board and inform anaesthetist on call. Single lumen catheters are preferred for TPN. If a triple lumen catheter is used, a single port should be reserved for TPN alone.

When central lines are removed, the distal 5 cm. of the catheter tip should be sent for culture if catheter sepsis is suspected or blood cultures are positive.

Both insertion and removal of any line should be documented in patient's clinical notes. If not, it is difficult to confirm whether or not for example a bacteraemia is line-associated



Adrian P. Ireland