A CVC or “central line” is a small catheter that is inserted into large veins in either the neck (internal jugular vein), chest (subclavian vein) or groin (femoral vein). Its tip sits close to the heart and allows us to administer potent medications to support the heart and blood pressure and also to deliver other treatments. We also use a CVC to measure pressures and sample blood. A vascath is a device similar to a CVC except larger (and often with less access ports) and used for when people need dialysis (renal replacement therapy).
The Procedure
Under sterile conditions and using local anaesthetic to numb the skin, a medical officer inserts it into a large vein in the neck, beneath the collar bone, or into the groin. They may be placed in either the Emergency Department, the Operating Theatre, the ICU, or occasionally in the Radiology Department. A chest x-ray is used to confirm positioning in CVCs inserted in the neck or chest.
The Risks
Inability or difficulty during insertion due to anatomy is relatively common. There is a risk of the needle damaging other nearby structures during insertion such as arteries or nerves, and the risk of bleeding. CVCs inserted in the neck or under the collar bone may occasionally puncture the lung. Arrythmias may be caused during insertion but are generally short lived. Central line infections can be serious however we monitor patients and central lines closely for such complications.
