Central Line Protocol Checklist

Intravenous medications treat conditions including infections, pain and cardiac problems. A doctor, nurse or paramedic can insert an IV line into a vein in the patient's arm or hand, referred to as a peripheral vein. When the health care professional cannot establish an IV line in a peripheral vein, she will consider a central line insertion. A central line is an IV line established in one of the major blood vessels. Typically, a physician will place a central line in the jugular vein of the neck or the subclavian vein of the chest. A central line checklist guides proper placement and checks for problems.

Ensure Placement

• After insertion, the physician checks the central line for proper placement. She aspirates each lumen catheter of the line make sure of its location in the vein. The physician then takes an X-ray of the area of insertion to ensure the placement is correct and no problems, such as pneumothorax, have occurred because of the central line insertion.

Check Access

• The health care provider checks for ease of access to make sure each catheter is working properly prior to use. He looks for blockages by using a saline flush. Resistance may result from a kink in the line caused by improper patient positioning, such as the patient lying on the line. The provider repositions the patient and rechecks the line's placement to ensure it has remained in the proper location if resistance occurred. The catheters are ready for use if no problems exist.

Look for Infection

• Practitioners then look for signs of infection, which include fever, tenderness at the site, redness and swelling around the central line location. A physical exam, which involves looking at and touching the area of insertion, helps identify signs of infection. Blood tests will also detect the presence of infection. If an infection exists, the medical professional contacts the patient's physician immediately.