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)]]
* [[Central Venous Catheter at 2300 (TISS Item)]]
* {{TISS w Nr | Central venous catheter (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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*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:==
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*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)
== TISS Special Cases ==
{{DA | Are the following special cases really only for TISS or should they apply for the other purposes above? Ttenbergen 12:35, 2019 January 21 (CST)}}
=== Special Case - Code '''peripheral''' PICC lines ===
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.
=== Special Case - unused, fully buried (entirely internal) vascular access devices (such as Port-a-Cath) ===
*We previously said NOT to count these in TISS if they've not been accessed at all during the admission.  However, this ignores the situation when it might well have been accessed at a time prior to but close to admission (e.g. got chemotherapy through it in the Onc Clinic as an outpatient a few days prior to admission).  Because the possibilities here are so numerous, for simplicity, we WILL count these on TISS even if not being used (per Allan, Dec 28, 2018).


== Legacy ==
== Legacy ==

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.

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