Central Line: Difference between revisions

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(clean-up and integration, make sure I didn't miss anything)
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* [[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]]
* [[QA Infection CLI]]
* [[Central Line Tracking]]
and by the following for venous lines
* [[Central Venous Catheter at 2300 (TISS Item)]]
* [[Central Venous Catheter at 2300 (TISS Item)]]
* [[Central venous catheter (TISS Item)]]
* [[Central venous catheter (TISS Item)]]
== Not collected in CCI ==
We do not collect Central Line information in CCI because it is already coded in TISS. We realize we will not get the type of line used that way and that is OK. <!-- discussed 2018-06-20 w Allan Garland -->


=='''CL''' means '''Central Line''' ==
=='''CL''' means '''Central Line''' ==
*A CL is a vascular access catheter that passes through or has a tip ending 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 may be used for infusion, blood sampling, or hemodynamic monitoring.  
*It can be temporary, or long-term/permanent.  
*It can be temporary, or long-term/permanent.  


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


=='''Vascular access Catheters'''==
=== vascular access catheter ===
*subclavian vein catheter
*subclavian vein catheter
*internal jugular vein catheter
*internal jugular vein catheter
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*Broviac
*Broviac
*Groshong
*Groshong
*Quinton
*Hickman
*Hickman
*ASHE catheter
*hemodialysis catheter (e.g. Vascath)
*hemodialysis catheter (e.g. Vascath)
*implanted ports (e.g. Port-a-cath)
*implanted ports (e.g. Port-a-cath)
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*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)


== Code peripheral PICC lines ==
== 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.
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.


== what are included ==
== Special Case - unused implanted devices ==
'''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?''' 
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.''
*''Yes to all of the above if they meet the definition. Central lines are not defined by the type of device.''
{{discussion}}  
{{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)
* 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?''' 
== Not collected in CCI ==
**''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.''
We do not collect Central Line information in CCI because it is already coded in TISS. We realize we will not get the type of line used that way and that is OK. <!-- discussed 2018-06-20 w Allan Garland --> See also: [[List of CCI procedures we don't code]]


==Frequently asked questions==
{{Discuss | who=Allan | question=no TISS in medicine, so if we don't collect Central lines in CCI we will lose all info about it. Is that OK? }}
{{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)


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

Revision as of 21:07, 2018 October 1

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

CL means Central Line

  • 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
  • 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

Not counted as Central Lines:

  • arterial catheters inserted into an artery
  • ECMO
  • IABP
  • VAD; IMPELLA
  • A-V fistula
  • regular peripheral IVs
  • any intravascular device that does not have a lumen (e.g. pacemaker wires)

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.--Michelle Lagadi--2015 September 16.

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. Template: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)

Not collected in CCI

We do not collect Central Line information in CCI because it is already coded in TISS. We realize we will not get the type of line used that way and that is OK. See also: List of CCI procedures we don't code

no TISS in medicine, so if we don't collect Central lines in CCI we will lose all info about it. Is that OK?

  • SMW


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