36556 Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older

Name of the Procedure:

Insertion of Non-tunneled Centrally Inserted Central Venous Catheter Common names: Central Line, CVC Insertion

Summary

The insertion of a non-tunneled centrally inserted central venous catheter (CVC) is a medical procedure in which a long, thin tube is placed into a large vein in the neck, chest, or groin. This catheter is used to deliver medication, fluids, nutrients, or to draw blood. For patients age 5 years or older, this procedure assists in various treatments and monitoring within a healthcare setting.

Purpose

This procedure addresses the need for long-term intravenous (IV) access. The goals include administering medications, chemotherapy, parenteral nutrition, or drawing blood samples without repeated needle sticks.

Indications

• Patients needing long-term IV therapy
• Difficulty in obtaining peripheral IV access
• Administration of irritant or vesicant medications
• Frequent blood sampling requirement

Preparation

• fasting may be required before the procedure.
• Adjustments to regular medications will be discussed.
• Diagnostic tests such as blood tests or imaging (e.g., ultrasound) may be needed.

Procedure Description

1. The patient is positioned comfortably, and the insertion site is cleaned and sterilized.
2. Local anesthesia or sedation is administered to minimize discomfort.
3. Using ultrasound guidance, the physician inserts a needle into a large vein.
4. A guidewire is threaded through the needle, and the needle is removed.
5. A catheter is threaded over the guidewire and advanced into the vein.
6. The guidewire is removed, and the catheter is secured in place.
7. The catheter is flushed with saline, and a sterile dressing is applied.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

Performed in a hospital setting, either in an operating room, interventional radiology suite, or ICU.

Personnel

• Interventional radiologist or specially trained physician
• Nurse
• Anesthesiologist or sedation nurse (if sedation is used)
• Radiologic technologist (if imaging is used)

Risks and Complications

• Infection at the insertion site
• Bleeding or hematoma
• Pneumothorax (collapsed lung)
• Thrombosis (blood clots)
• Catheter malposition or malfunction

Benefits

• Reliable long-term venous access
• Reduced need for repeated needle sticks
• Effective delivery of medications and nutrition
• Facilitation of frequent blood draws

Recovery

• Post-procedure monitoring for a few hours
• Keep the insertion site clean and dry
• Follow-up appointments for dressing changes and catheter maintenance
• Avoid heavy lifting and strenuous activities for a specified period

Alternatives

• Peripheral IV line: suitable for short-term use but may be less reliable
• Peripherally inserted central catheter (PICC): can be used for intermediate durations
• Implanted ports: suitable for long-term IV access with less frequent needling but require surgical placement

Patient Experience

During the procedure, patients may feel slight pressure or discomfort. Post-procedure, there may be minor soreness at the insertion site. Pain management includes prescribed medications and keeping the site clean to avoid infection.