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 ==
=== Special Case - Code '''peripheral/midline'''  PICC lines ===
*We will not consider a so-called midline PICC (which is not technically a Peripherally Inserted Central Catheter at all, because it doesn't end in a central vein) as a CVC for any purpose as of January 2019.  The reasons are: (a) as above it's not a central catheter, and (b) it does not have the same infection risk as a central catheter (ref is: 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). 
**While it does have similar nursing workload as a PICC or an untunelled CVC, the fact is that the use of our TISS scoring to measure nursing workload is a relatively rare/minor use.


== 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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