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  
* [[Central Line Related Blood stream Infection (CLR-BSI)]]
* [[Iatrogenic, infection, central venous catheter-related bloodstream infection (CVC-BSI, CLI)]]
* [[QA Infection CLI]]
* {{TISS w Nr | Central venous catheter (TISS Item)}}
and by the following for venous lines
* [[CVC placement, any location]]
* [[Central Venous Catheter at 2300 (TISS Item)]]
* ''(legacy) {{TISS w Nr | Central Venous Catheter at 2300 (TISS Item)}}''
* [[Central venous catheter (TISS Item)]]


=='''CL''' means '''Central Line''' ==
== Definition ==
A CL is a vascular access catheter that passes through or has a tip ending at or close to the heart or in one of the great vessels.
*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 can be temporary, or long-term/permanent.  


=='''Great vessels''' include:==
===great vessel===
*aorta
*aorta
*pulmonary artery
*pulmonary artery
Line 21: Line 22:
*femoral veins
*femoral veins


=='''Central Lines''' include:==
=== vascular access catheter ===
*subclavian vein catheter
*subclavian vein catheter
*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]]'''
*Brovic
*Broviac
*Groshong
*Groshong
*Quinton
*Hickman
*Hickman
*Dialysis catheter  
*ASHE catheter
*introducer for temporary pacing wire
*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:==
=='''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
*[[VAD]]; IMPELLA
*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]].


== Code peripheral PICC lines ==
== Related Articles ==
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.
{{Related Articles}}


== what are included ==
[[Category:Central lines| *]]
'''Do central lines include the following: implantable-ports, non tunneled TLC, Swan Ganz catheter, tunneld-Borviac, Groshong, Quinton, Hickman, ASHE catheter, PICC lines?  If yes would they be counted in the central line days for that unit?''' 
#*''Yes to all of the above if they meet the definition.  Central lines are not defined by the type of device.''
{{discussion}}
* That answer seems to go directly against the definition in here... can we get rid of it?
 
 
#'''Is a dialysis catheter considered a central line since it isn't used for infusion?''' 
#*''A dialysis catheter is considered a central line if it meets the definition of a central line. It is used for infusion of the patient's own blood.''
 
 
==Frequently asked questions==
{{discussion}}
This info would be better off integrated properly into the definitions above... Ttenbergen 20:07, 2017 September 12 (CDT)
 
#'''If a patient in an ICU has a temporary or tunneled hemodialysis catheter, is that device counted as a [[Central Line]] in the central line days?'''
#*''If a line meets the defintion of what is a central line, then it should be counted.  The only exception to this would be an implanted device that is not used.  In this situation, the line 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}}
* that info about actual use needs to be integrated above. Or does it not? 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)
 
 
 
[[Category:Central lines|*]]

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:
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