CENTRAL VENOUS ACCESS CATHETER PLACEMENT

What is a Central Venous Access Catheter?

A central venous access catheter (also called a central line or CVC) is a long, thin, flexible tube placed into a large central vein so that the tip rests near the heart (usually in the superior vena cava). This provides reliable, long-term access to the bloodstream.

Common types include:

  • PICC (Peripherally Inserted Central Catheter) — inserted in the upper arm
  • Non-tunneled central line — inserted in the neck (internal jugular), chest (subclavian), or groin (femoral)
  • Tunneled catheter (e.g., Hickman or Broviac) — tunneled under the skin for longer-term use
  • Implanted port — a small reservoir placed under the skin, accessed with a special needle

Why Do I Need a Central Venous Access Catheter?

A central line is recommended when peripheral IVs are not sufficient or practical. Common reasons include:

  • Long-term IV antibiotics, chemotherapy, or other medications that irritate smaller veins
  • Total parenteral nutrition (TPN) or high-volume fluid administration
  • Frequent blood draws or blood product transfusions
  • Poor peripheral venous access
  • Need for central venous pressure monitoring or certain critical care medications

How Do I Prepare for Placement?

Preparation is usually minimal but important:

  • Medications: Tell your team about all medications, especially blood thinners. Blood tests (clotting studies) may be ordered.
  • Allergies: Report allergies to chlorhexidine, latex, adhesives, or local anesthetics.
  • Eating/drinking: Follow specific instructions. Some procedures (especially those under sedation) require fasting.
  • Clothing: Wear loose clothing that allows easy access to the neck, chest, or arm.
  • Questions: Ask about the type of catheter planned, expected duration, and risks before consenting.

How is it Placed?

Placement is performed by a trained clinician (interventional radiologist, vascular access specialist, or intensive care provider) using sterile technique:

  • You will lie on your back. Monitors track your vital signs.
  • The insertion site is cleaned with chlorhexidine and draped with sterile covers.
  • Local anesthetic numbs the area. Sedation may be used for some procedures.
  • Ultrasound or fluoroscopy guides needle and catheter placement into the chosen vein.
  • The catheter is advanced so the tip rests in a large central vein near the heart.
  • Position is confirmed by imaging (chest X-ray or other method). The external portion is secured and dressed.

Care Instructions

Proper care is essential to prevent infection and keep the line working:

Dressing & Site Care

  • Keep the dressing clean, dry, and intact. Transparent dressings are usually changed every 7 days (or sooner if wet, dirty, or loose).
  • Dressing changes are performed using sterile technique by a trained nurse or caregiver.

Flushing & Access

  • Flush the line regularly with sterile saline (and heparin if ordered) to prevent clotting.
  • Always scrub the needleless connector with an alcohol swab for 15–30 seconds before any access.

Daily Habits

  • Wash hands thoroughly before touching the catheter.
  • Shower with a waterproof cover over the site. Avoid submerging the catheter (no baths, swimming, or hot tubs).
  • Avoid heavy lifting or activities that pull on the catheter. Do not have blood pressure taken or blood drawn from the same side if it is a PICC.

What to Watch Out For

Contact your healthcare provider promptly (or seek emergency care for severe symptoms) if you notice:

Infection Signs

  • Fever, chills, or feeling unwell
  • Redness, warmth, swelling, tenderness, or drainage at the insertion or exit site
  • Red streaking along the vein or path of the catheter

Other Complications

  • Swelling of the arm, neck, face, or chest on the same side
  • Difficulty flushing the line or inability to draw blood
  • Leakage of fluid or blood from the site or catheter
  • The catheter appears longer or shorter, or has been pulled
  • Shortness of breath, chest pain, rapid heartbeat, dizziness, or fainting
  • Numbness, tingling, or weakness in the arm or hand

Important Disclaimer

This document provides general patient education information about central venous access catheters. It is not a substitute for the specific instructions, training, or medical advice given by your physician, nurse, or healthcare team. Always follow the care plan and contact information provided to you.

Questions?

Speak with your nurse or provider.