Designed and created by Guideline Central in participation with the American Society of Anesthesiologists
Central Venous Access
Patient Guideline Summary
Publication Date: January 1, 2020
Last Updated: March 3, 2023
This patient summary means to discuss key recommendations from the American Society of Anesthesiologists for central venous access.
- 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.
- 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:
- 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.
- 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.
- Neck and chest sites minimize the risk of blood clots.
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.
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.