Clinical meaning
A central venous catheter (CVC) is placed with the tip in the superior vena cava or right atrium, providing venous access for vesicant medications, TPN, vasopressors, hemodynamic monitoring, and hemodialysis. Common insertion sites include the internal jugular, subclavian, and femoral veins. Peripherally inserted central catheters (PICCs) provide central access through arm veins. Central line-associated bloodstream infections (CLABSIs) are a leading cause of preventable healthcare-associated death, with mortality rates of 12-25%. The CLABSI prevention bundle includes hand hygiene, maximal sterile barrier precautions during insertion, chlorhexidine skin preparation, optimal catheter site selection (subclavian preferred for lowest infection risk), and daily review of line necessity with prompt removal when no longer needed. Hub contamination from healthcare workers' hands is the most common route of infection after insertion.
Exam relevance
Risk factors: - Prolonged central line dwell time - Femoral insertion site (highest infection and thrombosis risk) - Multiple lumens providing more access points for contamination - Frequent line access increasing hub contamination risk - Immunocompromised patients with impaired infection response