Central Line Tips & Tricks: Part 4

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Harman Gill
I am a proud Indian by ethnicity and Sikh by religion who lives in the lovely upper valley here in New Hampshire. I love to host, cook and engage in health conversations and loud debates where decibels can be raised but respect is never lost! Talk to you soon!
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Shyam Murali

Academic Chief Resident at Mercy St. Vincent Medical Center, pursuing a surgical critical care fellowship. His first steps into FOAMed started off with him learning something new each day and sharing it with MedTwitter. Days off include jamming on his saxophone, making EDM remixes, and spending quality time with his wife and puppy.

The Debrief

  1. Watch the video for all the tips on how to troubleshoot central lines
  2. Depending on the depth at which the wire gets stuck, there are different ways to troubleshoot when the wire doesn’t pass
  3. Consider the following techniques (based on where the wire gets stuck):
    • 2-10cm: remove the wire and needle and clear the needle of clots
    • 8-10cm: needle may have accidentally backwalled the vessel or come out of the vessel. Remove the wire, attach the syringe again and re-enter the center of the vessel.
    • 10-15cm: drop your angle, rotate your wire 90 degrees clockwise or counterclockwise
    • 15-25cm: pull back your wire and rotate slightly before advancing again (wire may get stuck at the IVC/subclavian junction)
  4. NEVER PUSH THROUGH RESISTANCE!

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