Central Venous Access

Patient Guideline Summary

Publication Date: January 1, 2020

Last Updated: March 3, 2023

Objective

This patient summary means to discuss key recommendations from the American Society of Anesthesiologists for central venous access.

Overview

Central venous access is a method of delivering fluids and medications directly to a patient while avoiding repeated injections and when arm veins are unavailable or unsuitable, as in long-term use.
This patient summary focuses on the proper insertion and use of central venous access.

Management

The usual sites for placement of a central venous line are the neck, behind the collar bone, and in the groin. The first two are generally preferred.
Among the several devices available, the appropriate one for each occasion must be carefully determined.
Standard-approved protocols are available for guidance when inserting and using the device.
There are several risks associated with central venous access:
- Infection
- Damage to nearby structures like arteries and the lungs
- Blood clots
It is important to secure the device so it remains in place and open.

Infection

Antibiotics can be coated on the access device or given through it to prevent infection.
Special dressings to cover the device and strict sterility when handling it are required.
Because infection risk increases over time, prompt removal when the device is no longer needed is necessary.

Damage to nearby structures

When inserting the device, imaging with ultrasound or x-ray is recommended.
When using the device, care must be taken not to dislodge it.
When removing the access, the entire device must be retrieved.

Blood clots

Neck and chest sites minimize the risk of blood clots.

Source Citation

Practice Guidelines for Central Venous Access 2020: An Updated Report by the American Society of Anesthesiologists Task Force on Central Venous Access. Anesthesiology. 2020 Jan;132(1):8-43. doi: 10.1097/ALN.0000000000002864. PMID: 31821240.

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.