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)]]
* [[CVC placement, any location]]
* [[Central venous catheter (TISS Item)]]
* ''(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)
 
== 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 --> See also: [[List of CCI procedures we don't code]]
 
 


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

Latest revision as of 16:04, 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: