CENTRAL VENOUS CATHETERIZATION（中央静脉导管插入术）.pdf

DISCLAIMER: These guidelines were prepared by the Department of Surgical Education, Orlando Regional Medical Center. They are intended to serve as a general statement regarding appropriate patient care practices based upon the available medical literature and clinical expertise at the time of development. They should not be considered to be accepted protocol or policy, nor are intended to replace clinical judgment or dictate care of individual patients. CENTRAL VENOUS CATHETERIZATION SUMMARY Over 5 million central venous catheters (CVC) are inserted annually in the United States for hemodynamic monitoring or medication administration. CVC are associated with significant infectious, mechanical, and thrombotic complications and should be discontinued when they are no longer needed for patient monitoring or resuscitation. Proper insertion technique is essential in order to prevent CVC- related complications from occurring. RECOMMENDATIONS • Level 1 Healthcare workers should be educated regarding the indications, proper insertion, maintenance, and appropriate infection control measures associated with CVC use. Full barrier precautions (cap, mask, sterile gown, sterile gloves, and large full-body drape) should be utilized during each CVC insertion. Good hand hygiene should be performed both before and after CVC insertion and maintenance. Meticulous aseptic technique should be maintained during CVC insertion and care. Skin asepsis should be obtained using 2% chlorhexidine gluconate prior to CVC insertion. The subclavian vein is the preferred site of CVC insertion. The femoral vein should be used only when the subclavian and internal jugula