Anchoring Central Lines
New Information About Inserting Central Venous Lines at BMC
I. New central line kits to prevent needle sticks during line anchoring.
10 – 20 % of all percutaneous exposures occurred while suturing skin or while anchoring a central line to skin.
These kits contain a suture with a curved needle, a forceps, and a needle holder for anchoring central venous lines.The needle should be handled only with the forceps and needle holder, not your fingers. The link to the left below will activate a video clip demonstrating how to anchor central lines with the new kits.
Rie Aihara, M.D.
Carol Sulis, M.D.,
Wayne LaMorte, M.D., M.P.H.
Erwin Hirsch, M.D.
II. Chlorhexadine-based skin prep to prevent blood stream infections:
A recent analysis suggested that 250,000 CVC-associated BSI occur in US hospitals each year1. Prospective studies show an attributable mortality of 12-25% and an attributable excess cost of $3,700 – $29,000 per infection1-3. One proven prevention strategy is the use of a 2% chlorhexadine-based skin prep prior to catheter insertion for patients greater than 2 months old. Boston Medical Center has purchased Chlora Prepä 3 ml. applicators for central line dressing kits. We are working towards including this product in the central line insertion kit.
References
1Kluger DM, Maki DG. The relative risk of intravascular device related bloodstream infections in adults. Abstracts of the 39th Interscience Conference on Antimicrobial Agents and Chemotherapy 1999:514.
2Maki DG, Mermel LA. Infections due to infusion therapy. In:Bennett JV, Brachman PS, eds. Hospital Infections. Philadelphia: Lippincott-Raven, 1998:689-724.
3Mermel LA. Prevention of intravascular catheter-related infections. Ann. Intern. Med. 2000;132:391-402.