![]() ![]() The randomized controlled trial, 3SITES, compared femoral vs internal jugular vs subclavian venous access, with the primary outcome being a composite of blood stream infection and DVT. ![]() Is this what the evidence shows? Why does the CDC recommend the subclavian site as the site of choice for temporary non-tunneled central lines, 3 and why don’t we follow this advice? 1,2 Interns and medical students are often taught that the femoral site has higher rates of infections, and the subclavian is technically difficult and risks the development of a pneumothorax. Is there a “best” site? Looking at some retrospective studies and meta-analyses, there is a suggestion that the internal jugular (IJ) is by far the most common site for central venous cannulation. Is a C-collar in place? Are the endotracheal tube straps in the way? Is there an overlying cellulitis of the groin? Will a large pannus make a femoral approach difficult? Is this line emergent and is an ultrasound readily available? Does the patient already have a pneumothorax or chest tube? Suffice to say, there are many reasons a site may or may not be ideal - so it is good to have choices. Often logistical concerns can contribute to our choice as well. Infection rates, risk of bleeding, risk to surrounding structures, incidence of deep venous thrombosis (DVT), and specific complications such as pneumothorax are all things to consider. When deciding which of the three typical sites (internal jugular, femoral, and subclavian) to choose for central venous access, much can go into the site selection. For additional information visit Linking to and Using Content from MedlinePlus.The need for a central line is commonplace in the emergency department and critical care units. Any duplication or distribution of the information contained herein is strictly prohibited without authorization. Links to other sites are provided for information only - they do not constitute endorsements of those other sites. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. This site complies with the HONcode standard for trustworthy health information: verify here. Learn more about A.D.A.M.'s editorial policy editorial process and privacy policy. is among the first to achieve this important distinction for online health information and services. follows rigorous standards of quality and accountability. is accredited by URAC, for Health Content Provider (URAC's accreditation program is an independent audit to verify that A.D.A.M. Do not let the catheter site go under water if you are soaking in the bathtub.Ī.D.A.M., Inc. When you do, make sure the dressings are secure and your catheter site is staying dry. Your provider will tell you when you can shower or bathe after surgery. A friend, family member, caregiver, or your provider may be able to help you. You will need to change it sooner if it becomes loose or gets wet or dirty. You should change the dressing about once a week. Use this sheet to help remind you of the steps. Follow your health care provider's instructions on changing your dressing. You'll need to change your dressing often, so that germs don't get into your catheter and make you sick. You may need extra nutrition because your bowels are not working correctly. ![]() You may need antibiotics or other medicines for weeks to months.Central venous catheters are used when people need medical treatment over a long period. ![]()
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