Central line associated infections cause thousands of deaths
each year, yet these infections are preventable.
What is a central line?
A central line (central venous catheter) is a tube that is
placed in a large vein in the neck, chest, or groin. It is used to
provide the patient with medication or fluids, or to collect blood for
medical testing. Central lines are
different from peripheral IV sites as these catheters access a major vein that
is close to the heart and can remain in place for extended periods of time, weeks or months.  |
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What is a central line associated bloodstream infection?
- Abbreviated CLABSI
- Serious infection
- Occurs when germs such as bacteria or viruses enter the bloodstream through the central line
- In some cases, germs are introduced into the blood stream
when the central line is accessed days or weeks after being inserted
Modifiable Risk Factors
“Insertion circumstances (Emergency > Elective)
Skill of inserter (General > Specialized)
Insertion Site (Femoral > Subclavian)
Skin antisepsis (70% alcohol, 10% povidone, chlorhexidine)Catheter lumens (Multilumen > Single lumen)
Duration of catheter use (Longer duration of use greater
risk of infection)
Barrier precautions” Source: http://www.healthcare.gov
Diagnosis
According to Dr.
Jeffery Band from http://www.uptodate.com/
one must meet at least one of the following criteria:
“Patient has a
recognized pathogen cultured from one or more blood cultures and the pathogen
is not related to an infection at another site.
Patient has fever,
chills, and/or hypotension as well as positive laboratory cultures from two or
more blood samples drawn on separate occasions which are not related to
infection at another site and do not reflect contamination.
Patient <1 year of
age has at least one of the following signs or symptoms: fever, hypothermia,
apnea, or bradycardia (in addition to above criteria).”
Drawing blood cultures
Should be obtained from two to four blood draws from separate
sites (right hand left forearm)
Should be drawn simultaneously
References:
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