Central Venous Catheter Kit

Central Venous Catheter kit: Central venous catheter insertion is a common and often, necessary procedure for the care of critically ill patients. Central venous access may be attained with various devices, depending on the indication for catheter insertion. Broadly, central venous catheters allow for the administration of vasoactive medications and agents that are known venous irritants but catheters are also used to perform dialysis or plasmapheresis, or as a conduit to insert additional devices for more complex procedures. This activity reviews central venous catheter insertion and highlights the role of the interprofessional team in managing patients who undergo this procedure. Objectives:

Identify the indications and contraindications for central venous catheter insertion.
Describe the technique involved in central venous catheter insertion.
Review the common complications of central venous catheter insertion.
Outline the importance of interprofessional team collaboration, communication, and care coordination to enhance the care of patients requiring central venous catheter insertion to improve outcomes.

There are relative and absolute contraindications to placing central venous catheters, and contraindications may be site-specific. Relative contraindications may be over-ruled by the urgency with which the catheter needs to be placed and thus require careful consideration of the patient’s underlying pathology and hemodynamic status. Absolute contraindications:

Active skin or soft tissue infection at the potential site of the central line.
Anatomical distortion at the site, which includes implantable/indwelling hardware, such as hemodialysis catheters and pacemakers.
Vascular injury proximal or distal to the site of the catheter insertion, such as in traumatic injuries.

Relative contraindications:

Coagulopathy, though the actual incidence of clinically important bleeding is around 0.8%.
Thrombocytopenia, which seems to correlate with a greater risk of adverse events.
Uncooperative awake patient.
Distortion of landmarks by congenital anomalies or trauma.
Morbid obesity.

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