Central Line: Difference between revisions

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This article defines Central Lines to make sure we use the same definition in  
This article defines Central Lines (CLs) to make sure we use the same definition in  
* [[Iatrogenic, infection, central venous catheter-related bloodstream infection (CVC-BSI, CLI)]]
* [[Iatrogenic, infection, central venous catheter-related bloodstream infection (CVC-BSI, CLI)]]
* [[QA Infection CLI]]
* {{TISS w Nr | Central venous catheter (TISS Item)}}
* [[Central Venous Catheter at 2300 (TISS Item)]]
* [[Central venous catheter (TISS Item)]]
* [[CVC placement, any location]]
* [[CVC placement, any location]]
* ''(legacy) {{TISS w Nr | Central Venous Catheter at 2300 (TISS Item)}}''


=='''CL''' means '''Central Line''' ==
== Definition ==
*A CL is a [[#vascular access catheter]] that passes through or has a tip ending in one of the [[#great vessel]]s.
*A CL is a [[#vascular access catheter]] that passes through or has a tip ending in one of the [[#great vessel]]s.
*It may be used for infusion, blood sampling, or hemodynamic monitoring.  
*It may be used for infusion, blood sampling, or hemodynamic monitoring.  
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*internal jugular vein catheter
*internal jugular vein catheter
*PICC (Peripherally Inserted Central Catheter)
*PICC (Peripherally Inserted Central Catheter)
*Swan-Ganz (pulmonary artery) catheter  
*Swan-Ganz (pulmonary artery) catheter -- note placement of this has its own code '''[[Swan-Ganz (Pulmonary Artery Flotation) Catheter placement]]'''
*Broviac
*Broviac
*Groshong
*Groshong
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*central line introducer -- i.e. even if it does not have a central line in it
*central line introducer -- i.e. even if it does not have a central line in it
*introducer for a temporary pacing wire
*introducer for a temporary pacing wire
*tunnelled line insertions in Interventional Radiology


=='''Not''' counted as Central Lines:==
=='''Not''' counted as Central Lines:==
*arterial catheters inserted into an artery
*arterial catheters inserted into an artery
*ECMO
*ECMO - ([[ECMO, VV]], [[ECMO, VA]])
*IABP
*[[IABP]]
*VAD; IMPELLA
*[[VAD]]; IMPELLA
*A-V fistula
*A-V fistula
*regular peripheral IVs
*regular peripheral IVs
*Midline PICC -- since these do not end in a central vein, AND they have a much lower infection rate (ref:DG Maki, DM Kluger and CJ Crnich.  The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies.  Mayo Clinic Proceedings 81(9):1159-1171, 2006)
*any intravascular device that does not have a lumen (e.g. pacemaker wires)
*any intravascular device that does not have a lumen (e.g. pacemaker wires)


== Special Case - Code '''peripheral''' PICC lines ==
== Legacy ==
Kendiss Olafson confirmed that PICC lines that are noted on x-ray to be peripheral are still to be coded in our TISS as a central line. They still carry the same implications for nursing workload and have the same risk for infection, so for purposes of TISS and CL-BSI counting, these PICCs should be treated as central.--[[User:Mlagadi|Michelle Lagadi]]--2015 September 16.
We also used to code [[QA Infection CLI]].
 
== Special Case - unused implanted devices ==
An implanted device that is not used would only be counted beginning on the first day that it is accessed (e.g., physician orders that the port-a-cath be flushed). Then it would be counted every day there after.''
 
* {{discussion}} Is that only for Central Line Counts or part of the definition when to consider a Central Line in general? Ttenbergen 20:07, 2017 September 12 (CDT) Ttenbergen 21:07, 2018 October 1 (CDT)


== Related Articles ==
== Related Articles ==

Latest revision as of 15:04, 2021 October 20

This article defines Central Lines (CLs) to make sure we use the same definition in

Definition

  • A CL is a #vascular access catheter that passes through or has a tip ending in one of the #great vessels.
  • It may be used for infusion, blood sampling, or hemodynamic monitoring.
  • It can be temporary, or long-term/permanent.

great vessel

  • aorta
  • pulmonary artery
  • superior vena cava
  • inferior vena cava
  • brachiocephalic veins
  • internal jugular veins
  • subclavian veins
  • external iliac veins
  • common iliac veins
  • femoral veins

vascular access catheter

  • subclavian vein catheter
  • internal jugular vein catheter
  • PICC (Peripherally Inserted Central Catheter)
  • Swan-Ganz (pulmonary artery) catheter -- note placement of this has its own code Swan-Ganz (Pulmonary Artery Flotation) Catheter placement
  • Broviac
  • Groshong
  • Quinton
  • Hickman
  • ASHE catheter
  • hemodialysis catheter (e.g. Vascath)
  • implanted ports (e.g. Port-a-cath)
  • central line introducer -- i.e. even if it does not have a central line in it
  • introducer for a temporary pacing wire
  • tunnelled line insertions in Interventional Radiology

Not counted as Central Lines:

  • arterial catheters inserted into an artery
  • ECMO - (ECMO, VV, ECMO, VA)
  • IABP
  • VAD; IMPELLA
  • A-V fistula
  • regular peripheral IVs
  • Midline PICC -- since these do not end in a central vein, AND they have a much lower infection rate (ref:DG Maki, DM Kluger and CJ Crnich. The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clinic Proceedings 81(9):1159-1171, 2006)
  • any intravascular device that does not have a lumen (e.g. pacemaker wires)

Legacy

We also used to code QA Infection CLI.

Related Articles

Related articles: